Individual provider Active NPI

Judson Moon, O.D.

  • Optometrist
  • Haddonfield, NJ
National Provider Identifier
1447288790
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00448100 Issued in NJ
Practice address
57B Kings Hwy E
Haddonfield, NJ 08033-2001
Phone
(856) 427-0788
Fax
(856) 216-9032
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27TO00038100 NJ
Optometrist 152W00000X 27OA00448100 NJ Primary

Addresses

Primary practice location

57B Kings Hwy E
Haddonfield, NJ 08033-2001

Mailing address

57 Kings Hwy E
Haddonfield, NJ 08033-2001
Phone (856) 427-0788

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
I20040302000765 NJ Practitioner - Optometry 9436046687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

57 Kings Hwy E
Haddonfield, NJ 08033-2001
Phone (856) 427-0788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27TO00038100NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Haddonfield Vision P.C. Optometrist CurrentSince Jan 1, 1992 Accepting new patients
Premier Eye Haddonfield LLC Optometrist Past Accepting new patients

Locations

57 Kings Hwy E
#B
Haddonfield, NJ 08033
Phone (609) 427-0788

57 Kings Hwy E
Haddonfield, NJ 08033
Phone (856) 427-0788

Interoperability endpoints

  • FHIR API: https://haddonfieldvision.ef.prod.fhir.ema-api.com/fhir/r4/

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1447288790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 KINGS HWY E",
            "city": "HADDONFIELD",
            "state": "NJ",
            "postal_code": "080332001",
            "telephone_number": "856-427-0788",
            "fax_number": "856-216-9032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57B KINGS HWY E",
            "city": "HADDONFIELD",
            "state": "NJ",
            "postal_code": "080332001",
            "telephone_number": "856-427-0788",
            "fax_number": "856-216-9032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "JUDSON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27TO00038100",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00448100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haddonfield, NJ

Sources for this page

Verify at the official NPI Registry.