Individual provider Active NPI

Minas John Nicholas, O.D.

  • Optometrist
  • Paramus, NJ
National Provider Identifier
1609950955
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00386-400 Issued in NJ
Practice address
340 N Rte 17
Paramus, NJ 07652-2906
Phone
(201) 262-7100
Fax
(201) 262-4318
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00386-400 NJ Primary

Addresses

Primary practice location

340 N Rte 17
Paramus, NJ 07652-2906

Mailing address

340 N RT 17
Paramus, NJ 07652-5105
Phone (201) 262-7100

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
I20111031000418 NJ Practitioner - Optometry 0840395497 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyexam Group - Totowa, P.a.Group PAC ID 5092772293, 4 clinicians
Eyexam Group P aGroup PAC ID 8325224330, 3 clinicians

Practice addresses (Care Compare)

125 US Hwy 46
Totowa, NJ 07512-2338
Phone (973) 890-7070

712 N State RT
Suite 17
Paramus, NJ 07652-3106
Phone (201) 262-7100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00386-400NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyexam Group P a Optometrist CurrentSince Feb 26, 1991 Accepting new patients

Locations

712 N State Rt 17
Paramus, NJ 07652
Phone (201) 262-7100

340 N State Rt 17
Paramus, NJ 07652
Phone (201) 262-7100

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1609950955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 N RT 17",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076525105",
            "telephone_number": "201-262-7100",
            "fax_number": "201-262-4318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 N RTE 17",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076522906",
            "telephone_number": "201-262-7100",
            "fax_number": "201-262-4318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "MINAS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00386-400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramus, NJ

Sources for this page

Verify at the official NPI Registry.