Jerrold Fruchtman, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

5084 Issued in NJ

Practice address

256 Columbia Tpke
Ste 211
Florham Park, NJ 07932-1231

Phone

(973) 301-0400

Fax

(973) 301-8928

NPI assigned

Mar 8, 2007

Last updated

Nov 28, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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

Specialty

Optometry

Education

State University of New York - State College Optometry, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ridgedale Eye AssociatesGroup PAC ID 6709119506, 3 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ridgedale Eye Associates

  dba Ridgedale Family Eye Care

  • Optometrist
  • Florham Park, NJ
  • NPI 1598236523
  Medicare reassignment Care Compare group NPD Authorized official
• Ridgedale Family Eye Care PC

  • Optometrist
  • Florham Park, NJ
  • NPI 1003260134
  Authorized official Same address or phone

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1518098524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 BROWNING RD",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070781115",
            "telephone_number": "973-912-7219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 COLUMBIA TPKE",
            "address_2": "STE 211",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321231",
            "telephone_number": "973-301-0400",
            "fax_number": "973-301-8928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRUCHTMAN",
        "first_name": "JERROLD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "5084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabella Freda, LAC
• Robert Saul Freid, MD
• Fresenius Medical Care Comprehensive CKD SE (CKD Services of New Jersey)
• Molly Fried, LCSW
• Jessica Marie Friedhoff, LSW
• Kennedy Ogbazion Gabre, M.D.
• Lilibeth Dy Gaerlan, P.T.
• Lorin Gaffen, MA, LPC, LCADC
• Isaac Galandauer, M.D.
• Gallery of Little Smiles, LLC

• Optometrist in Florham Park, NJ
• Providers in Florham Park, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.