Individual provider Active NPI

Karina Manukyan, OPHTHALMIC DISPENSER

  • Ophthalmic Technician/Technologist
  • New Brunswick, NJ
National Provider Identifier
1306130638
Registry record updated Jun 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Technician/TechnologistTaxonomy code 156FX1100X
License
31TD00373000 Issued in NJ
Practice address
1 Spring St
Unit 101
New Brunswick, NJ 08901-2276
Phone
(732) 246-6895
NPI assigned
Jun 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Technician/Technologist 156FX1100X 31TD00373000 NJ Primary

Addresses

Primary practice location

1 Spring St
Unit 101
New Brunswick, NJ 08901-2276

Mailing address

1 Spring St
Unit 101
New Brunswick, NJ 08901-2276
Phone (732) 246-6895

Other identifiers 1

IdentifierTypeStateIssuer
0165441MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
31TD00373000NJMDOphthalmic Technician/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Optical Boutique LLC Current Accepting new patients

Locations

1 Spring St
Ste 101
New Brunswick, NJ 08901
Phone (732) 202-0393

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307059200000",
    "number": "1306130638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SPRING ST",
            "address_2": "UNIT 101",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089012276",
            "telephone_number": "732-246-6895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SPRING ST",
            "address_2": "UNIT 101",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089012276",
            "telephone_number": "732-246-6895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANUKYAN",
        "first_name": "KARINA",
        "name_prefix": "Ms.",
        "credential": "OPHTHALMIC DISPENSER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-03",
        "last_updated": "2011-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1100X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ophthalmic",
            "state": "NJ",
            "license": "31TD00373000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0165441",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; 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.