Individual provider Active NPI

Chani Miller, O.D.

  • Optometrist
  • Highland Park, NJ
National Provider Identifier
1710005632
Registry record updated Aug 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00523800 Issued in NJ
Practice address
18 N 3Rd Ave
Highland Park, NJ 08904-2408
Phone
(732) 993-1111
Fax
(732) 993-1167
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00523800 NJ Primary

Addresses

Primary practice location

18 N 3Rd Ave
Highland Park, NJ 08904-2408

Mailing address

18 N 3Rd Ave
Highland Park, NJ 08904-2408
Phone (732) 993-1111

Other identifiers 1

IdentifierTypeStateIssuer
6511708MedicaidNJ

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
I20080724000613 NJ Practitioner - Optometry 5092888917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metuchen Vision LLCGroup PAC ID 2860890670, 5 clinicians

Practice addresses (Care Compare)

43 Bridge St
Metuchen, NJ 08840-2278
Phone (732) 248-8889

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00523800NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Metuchen Vision LLC Optometrist CurrentSince Mar 1, 2023 Accepting new patients

Locations

43 Bridge St
Metuchen, NJ 08840
Phone (732) 248-8889

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219363200000",
    "number": "1710005632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 N 3RD AVE",
            "city": "HIGHLAND PARK",
            "state": "NJ",
            "postal_code": "089042408",
            "telephone_number": "732-993-1111",
            "fax_number": "732-993-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 N 3RD AVE",
            "city": "HIGHLAND PARK",
            "state": "NJ",
            "postal_code": "089042408",
            "telephone_number": "732-993-1111",
            "fax_number": "732-993-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CHANI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2008-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00523800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6511708",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, NJ

Sources for this page

Verify at the official NPI Registry.