John Thomas Nutaitis, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00492101 Issued in NJ

Practice address

1206 Route 72 W
Manahawkin, NJ 08050-2414

Phone

(609) 597-8087

Fax

(609) 597-7192

NPI assigned

May 12, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southern Shores Eye Center, P.a.

  • Ophthalmology Physician
  • Manahawkin, NJ
  • NPI 1669421194

  Optometrist

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257724800000",
    "number": "1194775635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 ROUTE 72 W",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080502414",
            "telephone_number": "609-597-8087",
            "fax_number": "609-597-7192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 ROUTE 72 W",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080502414",
            "telephone_number": "609-597-8087",
            "fax_number": "609-597-7192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTAITIS",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2009-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00492101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3467007",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Nielsen-Kondak
• Edward J Niewiadomski, M.D.
• NJ Regional Ear Nose & Throat Center LLC
• Lori Nolan
• North Rainbow Emergency Physicians, LLC
• Brittany Jane Nycz, DPT
• Melissa O'Hara, M.S.C.C.C-SLP
• Angelina O'Toole
• Nicole Obenshine
• Ocean Acupuncture & Herbal Medicine

• Optometrist in Manahawkin, NJ
• Providers in Manahawkin, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.