Individual provider Active NPI

Emil Martirosyan, OD

  • Optometrist
  • Secaucus, NJ
National Provider Identifier
1407450299
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00702000 Issued in NJ
Practice address
400 Park PL
Secaucus, NJ 07094-3654
Phone
(201) 325-9277
Fax
(201) 325-9347
NPI assigned
Nov 23, 2020
Last updated
Aug 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00702000 NJ Primary

Addresses

Primary practice location

400 Park PL
Secaucus, NJ 07094-3654

Mailing address

PO Box 2192
Secaucus, NJ 07096-2192
Phone (201) 325-9277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240216001214 NJ Practitioner - Optometry 0547604639 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00702000NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Emil Martirosyan OD LLC Optometrist CurrentSince Jan 14, 2024 Accepting new patients

Locations

400 Park Pl
Secaucus, NJ 07094
Phone (201) 325-9275

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1407450299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2192",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070962192",
            "telephone_number": "201-325-9277",
            "fax_number": "201-325-9347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PARK PL",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070943654",
            "telephone_number": "201-325-9277",
            "fax_number": "201-325-9347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIROSYAN",
        "first_name": "EMIL",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-23",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00702000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Secaucus, NJ

Sources for this page

Verify at the official NPI Registry.