NPIMap

Organization Active NPI

Jersey Shore Eyecare

  • Durable Medical Equipment & Medical Supplies
  • Brick, NJ
National Provider Identifier
1366620668
Registry record updated Feb 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
D2257 Issued in NJ
Legal business name
JERSEY SHORE EYECARE
Practice address
105 Brick Mall
Brick, NJ 08723-4163
Phone
(732) 477-7101
Fax
(732) 477-7008
NPI assigned
Feb 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2008

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

Authorized official

Name
Chris Michael Krautheim, OPTICIAN
Title
Owner
Phone
(732) 477-7101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X D2257 NJ Primary

Addresses

Primary practice location

105 Brick Mall
Brick, NJ 08723-4163

Mailing address

105 Brick Mall
Brick, NJ 08723-4163
Phone (732) 477-7101

Other identifiers 1

IdentifierTypeStateIssuer
0037443-01MedicaidNJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1202428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202428800000",
    "number": "1366620668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 BRICK MALL",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087234163",
            "telephone_number": "732-477-7101",
            "fax_number": "732-477-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 BRICK MALL",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087234163",
            "telephone_number": "732-477-7101",
            "fax_number": "732-477-7008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY SHORE EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-08",
        "last_updated": "2008-02-08",
        "status": "A",
        "authorized_official_last_name": "KRAUTHEIM",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-477-7101",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NJ",
            "license": "D2257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0037443-01",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2008; 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.