Individual provider Active NPI

Thomas R. Conroy, O.D.

  • Corneal and Contact Management Optometrist
  • Bloomfield, NJ
National Provider Identifier
1679539662
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
27OA00550500 Issued in NJ
Practice address
108 Broughton Ave
Bloomfield, NJ 07003
Phone
(973) 743-1331
Fax
(973) 743-6577
NPI assigned
Apr 26, 2006
Last updated
Aug 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 27OA00550500 NJ Primary

Addresses

Primary practice location

108 Broughton Ave
Bloomfield, NJ 07003

Mailing address

108 Broughton Ave
Bloomfield, NJ 07003-3989
Phone (973) 743-1331

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
I20050817000035 NJ Practitioner - Optometry 8123058450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Associates of North Jersey PAGroup PAC ID 8325076375, 7 clinicians

Practice addresses (Care Compare)

600 Mount Pleasant Ave
Suite L
Dover, NJ 07801-1630
Phone (973) 366-1232

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Associates of North Jersey PA CurrentSince Apr 11, 2022 Accepting new patients

Locations

600 Mount Pleasant Ave
Ste L
Dover, NJ 07801
Phone (973) 366-0436

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, 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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1679539662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 BROUGHTON AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033989",
            "telephone_number": "973-743-1331",
            "fax_number": "973-743-6577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 BROUGHTON AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "07003",
            "telephone_number": "973-743-1331",
            "fax_number": "973-743-6577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONROY",
        "first_name": "THOMAS",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NJ",
            "license": "27OA00550500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, NJ

Sources for this page

Verify at the official NPI Registry.