Roger Allen Young, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00383700 Issued in NJ

Practice address

2004 Bayshore Rd
Villas, NJ 08251-1815

Phone

(609) 886-1578

Fax

(609) 886-3520

NPI assigned

Jul 14, 2005

Last updated

Mar 19, 2014By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Roger Young, PC

  dba Bayside Eye Center

  • Eyewear Supplier
  • Villas, NJ
  • NPI 1205881109
  Authorized official Same address or phone

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1396744124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 BAYSHORE RD",
            "city": "VILLAS",
            "state": "NJ",
            "postal_code": "082511815",
            "telephone_number": "609-886-1578",
            "fax_number": "609-886-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 BAYSHORE RD",
            "city": "VILLAS",
            "state": "NJ",
            "postal_code": "082511815",
            "telephone_number": "609-886-1578",
            "fax_number": "609-886-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "ROGER",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00383700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shore Atlantic Medicine LLC
• Stri LLC (AABA Family Medical Supply)
• The Arc of Cape May County, Inc.
• Sandra Ude, PHARMD
• Burton A. Waisbren Jr., MD
• Juana Maria Zegarra, LCSW

• Optometrist in Villas, NJ
• Providers in Villas, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; 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.