Active NPI
Bruce Michael Benerofe, M.D.
- Ophthalmology Physician
- Randolph, NJ
National Provider Identifier
1356559579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- MA43617
- Practice address
- 447 State Route 10
Suite 4
Randolph, NJ 07869-2132 - Phone
- (973) 361-5440
- NPI assigned
- May 20, 2007
- Last updated
- Jul 15, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | MA43617 | NJ | Primary |
Addresses
Primary practice location
447 State Route 10
Suite 4
Randolph, NJ 07869-2132
Mailing address
447 State Route 10
Suite 4
Randolph, NJ 07869-2132
Phone (973) 361-5440
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07446190H | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 5, 2026 through May 5, 2028
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- State University of New York at Buffalo School of Medicine, 1979
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
447 State Route 10 E
Suite 4
Randolph, NJ 07869-2132
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA43617 | NJ | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279152000000",
"number": "1356559579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "447 STATE ROUTE 10",
"address_2": "SUITE 4",
"city": "RANDOLPH",
"state": "NJ",
"postal_code": "078692132",
"telephone_number": "973-361-5440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "447 STATE ROUTE 10",
"address_2": "SUITE 4",
"city": "RANDOLPH",
"state": "NJ",
"postal_code": "078692132",
"telephone_number": "973-361-5440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENEROFE",
"first_name": "BRUCE",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-20",
"last_updated": "2010-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NJ",
"license": "MA43617",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07446190H",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Randolph, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; 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; Opt Out Affidavits.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.