William J Kustrup, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

25MA018330 Issued in NJ

Practice address

123 Franklin Corner Rd
Ste 207
Lawrenceville, NJ 08648-2526

Phone

(609) 896-9448

Fax

(609) 896-7052

NPI assigned

May 23, 2005

Reactivated

Oct 31, 2013

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Mercer Eye Associates PA

  • Eyewear Supplier
  • Lawrenceville, NJ
  • NPI 1245409945

  Ophthalmology

  NPD (past)
• Mercer Eye Associates PA

  • Specialist
  • Lawrenceville, NJ
  • NPI 1609821487
  NPD (past)

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383177600000",
    "number": "1295738417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 FRANKLIN CORNER RD",
            "address_2": "STE 207",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482526",
            "telephone_number": "609-896-9448",
            "fax_number": "609-896-7052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 FRANKLIN CORNER RD",
            "address_2": "STE 207",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482526",
            "telephone_number": "609-896-9448",
            "fax_number": "609-896-7052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSTRUP",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2013-10-31",
        "deactivation_date": "2008-03-10",
        "reactivation_date": "2013-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA018330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8626006",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Kukla, M.ED, A.T.,C
• Jaimee C Kukla, D.C.
• Chester B Kulak, DMD
• Erine Allison Kupetsky, D.O.
• Ashley B. Kussman, LPC
• Dario Vittorio La Rocca, M.D.
• Emily Lambert, LCSW
• Sandro Larocca, M.D.
• Jason Joseph Larson, M.ED., ATC, EMT
• Radhika Laskarzewski, M.D.

• Ophthalmology Physician in Lawrenceville, NJ
• Providers in Lawrenceville, NJ by specialty
• Ophthalmology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.