Individual provider Active NPI

David Keating Roell, O.D.

  • Optometrist
  • Egg Harbor Township, NJ
National Provider Identifier
1629023577
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OA5256 Issued in NJ
Practice address
3007 Ocean Heights Ave Ste 105
Egg Harbor Township, NJ 08234-7749
Phone
(609) 653-9933
NPI assigned
May 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OA5256 NJ Primary

Addresses

Primary practice location

3007 Ocean Heights Ave Ste 105
Egg Harbor Township, NJ 08234-7749

Mailing address

121 Lighthouse LN
Egg Harbor Township, NJ 08234-6990
Phone (609) 601-9982

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
I20050805000154 NJ Practitioner - Optometry 1658300108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CDR Eye Associates, Inc.Group PAC ID 3971685181, 2 clinicians

Practice addresses (Care Compare)

3007 Ocean Heights Ave
Suite 105
Egg Harbor TWP, NJ 08234-7749
Phone (609) 653-9933

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OA5256NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
CDR Eye Associates, Inc. Optometrist CurrentSince Jan 2, 2008 Accepting new patients

Locations

3007 Ocean Heights Ave
Ste 5
Egg Hbr Twp, NJ 08234

3007 Ocean Heights Ave
Ste 105
Egg Hbr Twp, NJ 08234
Phone (609) 653-9933

Organizations & group practices 1

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276560000000",
    "number": "1629023577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 LIGHTHOUSE LN",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082346990",
            "telephone_number": "609-601-9982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3007 OCEAN HEIGHTS AVE STE 105",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082347749",
            "telephone_number": "609-653-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROELL",
        "first_name": "DAVID",
        "middle_name": "KEATING",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2010-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "OA5256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Egg Harbor Township, NJ

Sources for this page

Verify at the official NPI Registry.