Individual provider Active NPI

Arun K Kaistha, O.D.

  • Optometrist
  • Hammonton, NJ
National Provider Identifier
1659460012
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
270A00591800 Issued in NJ
Practice address
120 S White Horse Pike
Suite B2
Hammonton, NJ 08037-1804
Phone
(609) 567-0997
Fax
(609) 567-0515
NPI assigned
Oct 12, 2006
Last updated
Jun 25, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 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 270A00591800 NJ Primary

Addresses

Primary practice location

120 S White Horse Pike
Suite B2
Hammonton, NJ 08037-1804

Mailing address

120 S White Horse Pike
Suite B2
Hammonton, NJ 08037-1804
Phone (609) 567-0997

Other identifiers 1

IdentifierTypeStateIssuer
1659460012OtherNJNPI 1659460012

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
I20051108000106 NJ Practitioner - Optometry 2264345529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6981 N Park Dr
Suite 101
Pennsauken, NJ 08109-4201
Phone (856) 488-4404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
270A00591800NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper River Eye Associates Optometrist CurrentSince Sep 27, 2012 Accepting new patients
Jersey Eye Associates LLC Optometrist Current Accepting new patients
Joel Porter, M.D., L.L.C. PastSince Sep 27, 2012 Accepting new patients
Hammonton Family Eyecare, LLC Past Accepting new patients
Village Super Market of NJ LP Past Accepting new patients

Locations

6981 N Park Dr
Ste 101
Pennsauken, NJ 08109
Phone (856) 429-1415

Organizations & group practices 5

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277424000000",
    "number": "1659460012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S WHITE HORSE PIKE",
            "address_2": "SUITE B2",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "080371804",
            "telephone_number": "609-567-0997",
            "fax_number": "609-567-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S WHITE HORSE PIKE",
            "address_2": "SUITE B2",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "080371804",
            "telephone_number": "609-567-0997",
            "fax_number": "609-567-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAISTHA",
        "first_name": "ARUN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2010-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "270A00591800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI 1659460012",
            "identifier": "1659460012",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammonton, NJ

Sources for this page

Verify at the official NPI Registry.