Individual provider Active NPI

Barry Tannen, O.D.

  • Optometrist
  • Hamilton Square, NJ
National Provider Identifier
1730220211
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00431000 Issued in NJ
Practice address
1777 Kuser Rd
Hamilton Square, NJ 08690-3703
Phone
(609) 581-5755
Fax
(609) 581-7055
NPI assigned
Feb 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vision Therapy Optometrist 152WV0400X 4203 NY
Optometrist 152W00000X 27OA00431000 NJ Primary

Addresses

Primary practice location

1777 Kuser Rd
Hamilton Square, NJ 08690-3703

Mailing address

1777 Kuser Rd
Hamilton Square, NJ 08690-3703
Phone (609) 581-5755

Other identifiers 1

IdentifierTypeStateIssuer
521680OtherNJMEDICARE GROUP

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
I20110310000337 NJ Practitioner - Optometry 4284756818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyecare Professionals P.C.Group PAC ID 7719006469, 3 clinicians

Practice addresses (Care Compare)

1777 Kuser Rd
Hamilton Square, NJ 08690-3703
Phone (609) 581-5755

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00431000NJMDOptometrist
4203NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecare Professionals, P.C. Optometrist CurrentSince Jan 1, 1989 Accepting new patients

Locations

1777 Kuser Rd
Trenton, NJ 08690
Phone (609) 581-5755

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1730220211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 KUSER RD",
            "city": "HAMILTON SQUARE",
            "state": "NJ",
            "postal_code": "086903703",
            "telephone_number": "609-581-5755",
            "fax_number": "609-581-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 KUSER RD",
            "city": "HAMILTON SQUARE",
            "state": "NJ",
            "postal_code": "086903703",
            "telephone_number": "609-581-5755",
            "fax_number": "609-581-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNEN",
        "first_name": "BARRY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "NY",
            "license": "4203",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00431000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "521680",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton Square, NJ

Sources for this page

Verify at the official NPI Registry.