Individual provider Active NPI

Michelle V Timko, O.D.

  • Optometrist
  • Somerville, NJ
National Provider Identifier
1548339690
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00524800 Issued in NJ
Practice address
50 Division St Ste 101
Somerville, NJ 08876-2943
Phone
(908) 635-3365
Fax
(908) 210-9500
NPI assigned
Nov 6, 2006
Last updated
Nov 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 27OA00524800 NJ
Optometrist 152W00000X 27OA00524800 NJ Primary

Addresses

Primary practice location

50 Division St Ste 101
Somerville, NJ 08876-2943

Mailing address

192 Fairfield LN
Hillsborough, NJ 08844-1707
Phone (908) 672-9417

Other practice location 1

400 Commons Way
Suite 354
Bridgewater, NJ 08807-2800
Phone (908) 725-0008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00524800NJMDCorneal and Contact Management Optometrist

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1548339690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 FAIRFIELD LN",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088441707",
            "telephone_number": "908-672-9417",
            "fax_number": "908-725-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 DIVISION ST STE 101",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088762943",
            "telephone_number": "908-635-3365",
            "fax_number": "908-210-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Commons Way",
            "address_2": "Suite 354",
            "address_purpose": "LOCATION",
            "city": "Bridgewater",
            "state": "NJ",
            "postal_code": "088072800",
            "country_code": "US",
            "telephone_number": "908-725-0008",
            "fax_number": "908-725-0078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIMKO",
        "first_name": "MICHELLE",
        "middle_name": "V",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NJ",
            "license": "27OA00524800",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00524800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.