Individual provider Active NPI

Robert Schorn Purnell, OD

  • Optometrist
  • Rutherford, NJ
National Provider Identifier
1427000389
Registry record updated Oct 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
05447 Issued in NJ
Practice address
31 Park Ave
Rutherford, NJ 07070-1711
Phone
(201) 939-2463
Fax
(201) 939-1454
NPI assigned
May 17, 2006
Last updated
Oct 23, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2008

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 05447 NJ Primary
Corneal and Contact Management Optometrist 152WC0802X 05447 NJ
Sports Vision Optometrist 152WS0006X 05447 NJ
Occupational Vision Optometrist 152WX0102X 05447 NJ

Addresses

Primary practice location

31 Park Ave
Rutherford, NJ 07070-1711

Mailing address

31 Park Ave
Rutherford, NJ 07070-1711
Phone (201) 939-2463

Other identifiers 1

IdentifierTypeStateIssuer
7714106MedicaidNJ

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
I20050425000985 NJ Practitioner - Optometry 9133168636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

31 Park Ave
Rutherford, NJ 07070-1711
Phone (201) 939-2463

31 Park Ave
Rutherford, NJ 07070-1795

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05447NJMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Robert Schorn Purnell LLC Optometrist CurrentSince Jan 2, 2005 Accepting new patients

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224720000000",
    "number": "1427000389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 PARK AVE",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "070701711",
            "telephone_number": "201-939-2463",
            "fax_number": "201-939-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 PARK AVE",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "070701711",
            "telephone_number": "201-939-2463",
            "fax_number": "201-939-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURNELL",
        "first_name": "ROBERT",
        "middle_name": "SCHORN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2008-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "05447",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NJ",
            "license": "05447",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "NJ",
            "license": "05447",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "NJ",
            "license": "05447",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7714106",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutherford, NJ

Sources for this page

Verify at the official NPI Registry.