Individual provider Active NPI

Noorevelyn Sarsar

  • Optometrist
  • Shrewsbury, NJ
National Provider Identifier
1215627377
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00720500 Issued in NJ
Practice address
280 Shrewsbury PLZ
Shrewsbury, NJ 07702-4324
Phone
(732) 460-0916
NPI assigned
May 11, 2023
Last updated
Jun 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Optometrist 152W00000X 27OA00720500 NJ Primary

Addresses

Primary practice location

280 Shrewsbury PLZ
Shrewsbury, NJ 07702-4324

Mailing address

5 Pilgrim Ave
Tinton Falls, NJ 07753-7824

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230802004396 NJ Practitioner - Optometry 3971964263 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00720500NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Charles M Cummins, OD, PA Optometrist CurrentSince Jun 28, 2023 Accepting new patients
Charles M. Cummins, OD., PA Optometrist CurrentSince Jun 28, 2023 Accepting new patients
Charles M. Cummins, OD, PA Optometrist PastSince May 14, 2023 Accepting new patients

Locations

1255 Broad St
Bloomfield, NJ 07003
Phone (973) 338-7575

588 Route 70
Ste 9
Brick, NJ 08723
Phone (732) 864-0755

280 Shrewsbury PLZ
Shrewsbury, NJ 07702
Phone (732) 460-0916

2 Route 37 W
Toms River, NJ 08753
Phone (732) 286-7800

2 Route 37 W
Ste G5
Toms River, NJ 08753
Phone (732) 797-0104

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1215627377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PILGRIM AVE",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077537824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 SHREWSBURY PLZ",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "077024324",
            "telephone_number": "732-460-0916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARSAR",
        "first_name": "NOOREVELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-11",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00720500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shrewsbury, NJ

Sources for this page

Verify at the official NPI Registry.