Individual provider Active NPI

J J Suydam, OD

  • Optometrist
  • Pottstown, PA
National Provider Identifier
1750367363
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000916 Issued in PA
Practice address
2087 E High St
Pottstown, PA 19464
Phone
(610) 323-0133
Fax
(610) 323-3224
NPI assigned
Dec 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 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 OEG000916 PA Primary

Addresses

Primary practice location

2087 E High St
Pottstown, PA 19464

Mailing address

2087 E High St
Pottstown, PA 19464-3211
Phone (610) 323-0133

Other identifiers 1

IdentifierTypeStateIssuer
01156230MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20110329000822 PA Practitioner - Optometry 1254419310 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2087 E High St
Pottstown, PA 19464-3211
Phone (215) 323-0133

Merit-based Incentive Payment System (MIPS)

Final score
7.5 of 100Reported as individual
Quality
15
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG000916PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
J James Suydam OD PC Optometrist CurrentSince Feb 2, 1987 Accepting new patients

Locations

1800 E High St
Pottstown, PA 19464
Phone (484) 933-4370

2087 E High St
Pottstown, PA 19464
Phone (215) 323-0133

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": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200355200000",
    "number": "1750367363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2087 E HIGH ST",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194643211",
            "telephone_number": "610-323-0133",
            "fax_number": "610-323-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2087 E HIGH ST",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "19464",
            "telephone_number": "610-323-0133",
            "fax_number": "610-323-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUYDAM",
        "first_name": "J",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2008-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01156230",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pottstown, PA

Sources for this page

Verify at the official NPI Registry.