Jennifer Chan, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00728100 Issued in NJ

Practice address

1907 Deptford Center Rd
Woodbury, NJ 08096-5633

Phone

(856) 232-5492

NPI assigned

Jun 3, 2024

Last updated

Jun 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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.

• Charles M. Cummins, OD., PA

  dba EyeDRx

  • Optometrist
  • Bloomfield, NJ
  • NPI 1598797722
  Medicare reassignment NPD
• Charles M Cummins, OD, PA

  dba Visionworks Doctors of Optometry

  • Eyewear Supplier
  • Turnersville, NJ
  • NPI 1114703956

  Optometrist

  NPD

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1619718939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 DEPTFORD CENTER RD",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080965633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 DEPTFORD CENTER RD",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080965633",
            "telephone_number": "856-232-5492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JENNIFER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00728100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David D Carrozzino, DPM
• Patricia Marie Cassady, PH.D.
• Peter M Castelluccio, LSW
• Center for Family Services, Inc.
• Christina Chambers, PHD, LMFT
• Indira Michelle Chandler
• Charis Counseling, LLC
• Shaniece Latoya Chavis, DNP, APN, FNP-BC
• Ho-Kan Cheng, M.D.
• Abraham Cherian, MD

• Optometrist in Woodbury, NJ
• Providers in Woodbury, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.