Individual provider Active NPI

Robert N Diamond, OD

  • Optometrist
  • Lakewood, NJ
National Provider Identifier
1568437671
Registry record updated Aug 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OA04226 Issued in NJ
Practice address
101 Prospect St
Suite 102
Lakewood, NJ 08701-5003
Phone
(732) 367-0699
Fax
(732) 367-0937
NPI assigned
Feb 22, 2006
Last updated
Aug 16, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OA04226 NJ Primary
Optometrist 152W00000X TO000371 NJ

Addresses

Primary practice location

101 Prospect St
Suite 102
Lakewood, NJ 08701-5003

Mailing address

101 Prospect St
Suite 102
Lakewood, NJ 08701-5003
Phone (732) 367-0699

Other identifiers 1

IdentifierTypeStateIssuer
2620503OtherAETNA

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
I20060306000242 NJ Practitioner - Optometry 9739195439 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4226NJMDClinical Psychologist
OA04226NJMDOptometrist
TO000371NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
NJ Eye Consultants CurrentSince Mar 1, 2018 Accepting new patients
Ocean Eye Associates, Inc Optometrist Past Accepting new patients
Jersey Shore Eyecare Past Accepting new patients

Locations

101 Prospect St
Ste 102
Lakewood, NJ 08701
Phone 732367063815

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376611200000",
    "number": "1568437671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PROSPECT ST",
            "address_2": "SUITE 102",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015003",
            "telephone_number": "732-367-0699",
            "fax_number": "732-367-0937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PROSPECT ST",
            "address_2": "SUITE 102",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015003",
            "telephone_number": "732-367-0699",
            "fax_number": "732-367-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAMOND",
        "first_name": "ROBERT",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2013-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "OA04226",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "TO000371",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2620503",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.