Organization Active NPI

William C. Fruchtman OD PA

  • Optometrist
  • East Rutherford, NJ
National Provider Identifier
1407881667
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
WILLIAM C. FRUCHTMAN OD PA
Practice address
196 Paterson Ave
East Rutherford, NJ 07073-1841
Phone
(201) 728-9222
Fax
(201) 728-9229
NPI assigned
Jul 12, 2006
Last updated
Mar 20, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Authorized official

Name
Dr. William Charles Fruchtman, O.D.NPI 1447200241
Title
Optometric Physician
Phone
(201) 728-9222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

196 Paterson Ave
East Rutherford, NJ 07073-1841

Mailing address

196 Paterson Ave
East Rutherford, NJ 07073-1841
Phone (201) 728-9222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060808000353 NJ Part B Supplier - Clinic/Group Practice 5496758765 Receives reassigned benefits from 1 practitioner
Practice locations: East Rutherford, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489968000000",
    "number": "1407881667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 PATERSON AVE",
            "city": "EAST RUTHERFORD",
            "state": "NJ",
            "postal_code": "070731841",
            "telephone_number": "201-728-9222",
            "fax_number": "201-728-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 PATERSON AVE",
            "city": "EAST RUTHERFORD",
            "state": "NJ",
            "postal_code": "070731841",
            "telephone_number": "201-728-9222",
            "fax_number": "201-728-9229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM C. FRUCHTMAN OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2017-03-20",
        "status": "A",
        "authorized_official_last_name": "FRUCHTMAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OPTOMETRIC PHYSICIAN",
        "authorized_official_telephone_number": "201-728-9222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Rutherford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.