Individual provider Active NPI

David Weininger, O.D.

  • Optometrist
  • New Brunswick, NJ
National Provider Identifier
1477554426
Registry record updated May 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3854 Issued in NJ
Practice address
177 Easton Ave
New Brunswick, NJ 08901-1719
Phone
(732) 545-6035
Fax
(732) 249-6952
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3854 NJ Primary

Addresses

Primary practice location

177 Easton Ave
New Brunswick, NJ 08901-1719

Mailing address

177 Easton Ave
New Brunswick, NJ 08901-1719
Phone (732) 545-6035

Other identifiers 2

IdentifierTypeStateIssuer
1962001MedicaidNJ
40848OtherNJAETNA

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
I20110318000589 NJ Practitioner - Optometry 9830305200 Practice locations: New Brunswick, NJ

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

177 Easton Ave
New Brunswick, NJ 08901-1719
Phone (732) 545-6035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3854NJMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337644800000",
    "number": "1477554426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 EASTON AVE",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011719",
            "telephone_number": "732-545-6035",
            "fax_number": "732-249-6952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 EASTON AVE",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011719",
            "telephone_number": "732-545-6035",
            "fax_number": "732-249-6952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEININGER",
        "first_name": "DAVID",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2012-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "3854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962001",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "40848",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.