Organization Active NPI

Amesur Eye Associates, P.a.

  • Ophthalmology Physician
  • Ridgewood, NJ
National Provider Identifier
1265749964
Registry record updated May 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
25MA07468300 Issued in NJ
Legal business name
AMESUR EYE ASSOCIATES, P.A.
Practice address
947 Linwood Ave
Suite 2 South
Ridgewood, NJ 07450-2939
Phone
(201) 857-4751
Fax
(201) 857-4752
NPI assigned
Sep 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2011

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

Authorized official

Name
Dr. Kiran B Amesur, M.D.NPI 1104900778
Title
President
Phone
(201) 857-4751

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 25MA07468300 NJ Primary

Addresses

Primary practice location

947 Linwood Ave
Suite 2 South
Ridgewood, NJ 07450-2939

Mailing address

947 Linwood Ave
Suite 2 South
Ridgewood, NJ 07450-2939
Phone (201) 857-4751

Other identifiers 1

IdentifierTypeStateIssuer
065952OtherMEDICARE ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110506000085 NJ Part B Supplier - Clinic/Group Practice 9335324367 Receives reassigned benefits from 1 practitioner
Practice locations: Ridgewood, NJ

National Provider Directory

National Provider Directory

Locations

947 Linwood Ave
Ste 2S
Ridgewood, NJ 07450
Phone (201) 857-4751

Interoperability endpoints

  • Direct secure messaging: kamesur@amesureye.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304640000000",
    "number": "1265749964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "947 LINWOOD AVE",
            "address_2": "SUITE 2 SOUTH",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074502939",
            "telephone_number": "201-857-4751",
            "fax_number": "201-857-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "947 LINWOOD AVE",
            "address_2": "SUITE 2 SOUTH",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074502939",
            "telephone_number": "201-857-4751",
            "fax_number": "201-857-4752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMESUR EYE ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-02",
        "last_updated": "2011-05-06",
        "status": "A",
        "authorized_official_last_name": "AMESUR",
        "authorized_official_first_name": "KIRAN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-857-4751",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA07468300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "065952",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.