Corrine Como Bengzon, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00550000 Issued in NJ

Practice address

461 Route 10 Ste a 100
Legdewood, NJ 07852

Phone

(973) 252-2423

NPI assigned

Dec 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Charles M. Cummins, OD., PA

  • Optometrist
  • Bloomfield, NJ
  • NPI 1598797722
  Medicare reassignment NPD
• Charles M Cummins, OD, PA

  • Eyewear Supplier
  • Turnersville, NJ
  • NPI 1114703956

  Optometrist

  NPD
• Optometric Associates

  • Optometrist
  • Bridgewater, NJ
  • NPI 1689882326
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1457415283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 FAWNRIDGE DR",
            "city": "LONG VALLEY",
            "state": "NJ",
            "postal_code": "078533247",
            "telephone_number": "908-625-8491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 ROUTE 10 STE A 100",
            "city": "LEGDEWOOD",
            "state": "NJ",
            "postal_code": "07852",
            "telephone_number": "973-252-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMO BENGZON",
        "first_name": "CORRINE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00550000",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OM00025300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.