Individual provider Active NPI

Kathy Moreira, OD

  • Optometrist
  • Clifton, NJ
National Provider Identifier
1487722930
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00580600 Issued in NJ
Practice address
251 Clifton Ave
Clifton, NJ 07011-1961
Phone
(973) 340-2300
Fax
(973) 340-2306
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00580600 NJ Primary

Addresses

Primary practice location

251 Clifton Ave
Clifton, NJ 07011-1961

Mailing address

11103 West Ave
Suite 6
San Antonio, TX 78213-1370
Phone (210) 524-6509

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
I20050811000057 NJ Practitioner - Optometry 4880623776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charles M Cummins, OD, PAGroup PAC ID 0446246995, 24 clinicians

Practice addresses (Care Compare)

157 Route 10 E
Succasunna, NJ 07876-1431
Phone (973) 927-7717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Charles M. Cummins, OD, PA Optometrist CurrentSince Feb 2, 2018 Accepting new patients

Locations

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

501 N Route 17
Paramus, NJ 07652
Phone (201) 265-9400

157 State Route 10 E
Succasunna, NJ 07876
Phone (973) 927-7717

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

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1487722930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11103 WEST AVE",
            "address_2": "SUITE 6",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131370",
            "telephone_number": "210-524-6509",
            "fax_number": "210-524-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 CLIFTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070111961",
            "telephone_number": "973-340-2300",
            "fax_number": "973-340-2306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOREIRA",
        "first_name": "KATHY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00580600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.