Individual provider Active NPI

Ronald S Kowalik, OD

  • Optometrist
  • Garfield, NJ
National Provider Identifier
1457400517
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1608002 Issued in NJ
Practice address
57 Belmont Ave
Garfield, NJ 07026-3203
Phone
(973) 340-0489
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00299001 NJ
Optometrist 152W00000X K0521338 NJ
Optometrist 152W00000X 1608002 NJ Primary
Optometrist 152W00000X UPN U26870 NJ

Addresses

Primary practice location

57 Belmont Ave
Garfield, NJ 07026-3203

Mailing address

57 Belmont Ave
Garfield, NJ 07026-3203
Phone (973) 340-0489

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
I20120321000527 NJ Practitioner - Optometry 2567622038 Practice locations: Jersey City, NJ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2990NJMDSports Physician Chiropractor
1608002NJMDOptometrist
K0521338NJMDOptometrist
UPN U26870NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nobel Eyeglasses Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457400517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 BELMONT AVE",
            "city": "GARFIELD",
            "state": "NJ",
            "postal_code": "070263203",
            "telephone_number": "973-340-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 BELMONT AVE",
            "city": "GARFIELD",
            "state": "NJ",
            "postal_code": "070263203",
            "telephone_number": "973-340-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALIK",
        "first_name": "RONALD",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00299001",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "K0521338",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "1608002",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "UPN U26870",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garfield, NJ

Sources for this page

Verify at the official NPI Registry.