Individual provider Active NPI

Lisa M. Andrasz

  • Optometrist
  • Bordentown, NJ
National Provider Identifier
1447234976
Registry record updated Jan 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
AO-05361 Issued in NJ
Practice address
223 Farnsworth Ave
Bordentown, NJ 08505-1841
Phone
(609) 298-1072
Fax
(609) 298-6950
NPI assigned
Nov 29, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X AO-05361 NJ Primary

Addresses

Primary practice location

223 Farnsworth Ave
Bordentown, NJ 08505-1841

Mailing address

223 Farnsworth Ave
Bordentown, NJ 08505-1841
Phone (609) 298-1072

Other identifiers 2

IdentifierTypeStateIssuer
536716OtherNJAETNA
1130440001OtherNJSUPPLIER CLEARING HOUSE

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
I20101124000912 NJ Practitioner - Optometry 6709906795 Practice locations: Bordentown, NJ

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

223 Farnsworth Ave
Bordentown, NJ 08505-1841
Phone (609) 298-1072

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AO-05361NJMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391040000000",
    "number": "1447234976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 FARNSWORTH AVE",
            "city": "BORDENTOWN",
            "state": "NJ",
            "postal_code": "085051841",
            "telephone_number": "609-298-1072",
            "fax_number": "609-298-6950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 FARNSWORTH AVE",
            "city": "BORDENTOWN",
            "state": "NJ",
            "postal_code": "085051841",
            "telephone_number": "609-298-1072",
            "fax_number": "609-298-6950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRASZ",
        "first_name": "LISA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2014-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "AO-05361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "536716",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPPLIER CLEARING HOUSE",
            "identifier": "1130440001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bordentown, NJ

Sources for this page

Verify at the official NPI Registry.