Individual provider Active NPI

Gor Shigol, O.D.

  • Optometrist
  • Woodbridge, NJ
National Provider Identifier
1487038576
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00661900 Issued in NJ
Practice address
873 Saint Georges Ave
Woodbridge, NJ 07095
Phone
(732) 750-3900
Fax
(732) 750-4869
NPI assigned
Jul 17, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV008308 NY
Optometrist 152W00000X 27OA00661900 NJ Primary

Addresses

Primary practice location

873 Saint Georges Ave
Woodbridge, NJ 07095

Mailing address

210 Woodland Rd
New Milford, NJ 07646-2308

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
I20190109003178 NJ Practitioner - Optometry 9234446774 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV008308NYMDOptometrist
008308NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Charles M. Cummins, OD., PA Optometrist Current Accepting new patients
Charles M. Cummins, OD, PA Optometrist CurrentSince Dec 7, 2020 Accepting new patients
Charles M Cummins, OD, PA Optometrist CurrentSince Dec 7, 2020 Accepting new patients
Charles M Cummins OD PA Optometrist PastSince Jul 17, 2022 Accepting new patients

Locations

1255 Broad St
Bloomfield, NJ 07003
Phone (973) 338-7575

588 Route 70
Ste 9
Brick, NJ 08723
Phone (732) 864-0755

1255 Raritan Rd
Unit 740
Clark, NJ 07066
Phone (732) 388-4035

550 Old Post Rd
Edison, NJ 08817
Phone (732) 287-6600

120 Route 22
Springfield, NJ 07081
Phone (973) 379-5063

255 US Highway 46
Totowa, NJ 07512
Phone (973) 785-8000

873 Saint George Ave
Woodbridge, NJ 07095
Phone (732) 750-3900

Organizations & group practices 4

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": "1437091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1487038576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 WOODLAND RD",
            "city": "NEW MILFORD",
            "state": "NJ",
            "postal_code": "076462308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "873 SAINT GEORGES AVE",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "07095",
            "telephone_number": "732-750-3900",
            "fax_number": "732-750-4869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIGOL",
        "first_name": "GOR",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-17",
        "last_updated": "2022-08-02",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008308",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00661900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, NJ

Sources for this page

Verify at the official NPI Registry.