Active NPI
Walter John Shurminsky Jr., OD
- Optometrist
- Nutley, NJ
National Provider Identifier
1679556146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 270A00467800
- Practice address
- 420 Centre St
Nutley, NJ 07110-1635 - Phone
- (973) 667-0331
- Fax
- (973) 667-9673
- NPI assigned
- Nov 29, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 270A00467800 | NJ | Primary |
Addresses
Primary practice location
420 Centre St
Nutley, NJ 07110-1635
Mailing address
18 Fawn Hill Dr
Mahwah, NJ 07430-2829
Phone (201) 934-7317
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050425000061 | NJ | Practitioner - Optometry | 3274571500 | Practice locations: Ramsey, NJ |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
470 N Franklin Tpke
Suite 104
Ramsey, NJ 07446-1385
Phone (201) 825-8292
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 11 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4678 | NJ | MD | Clinical Psychologist |
| 270A00467800 | NJ | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332288000000",
"number": "1679556146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 FAWN HILL DR",
"city": "MAHWAH",
"state": "NJ",
"postal_code": "074302829",
"telephone_number": "201-934-7317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 CENTRE ST",
"city": "NUTLEY",
"state": "NJ",
"postal_code": "071101635",
"telephone_number": "973-667-0331",
"fax_number": "973-667-9673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHURMINSKY",
"first_name": "WALTER",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-29",
"last_updated": "2012-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NJ",
"license": "270A00467800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nutley, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.