NPIMap

Individual provider Active NPI

Surekha Collur, M.D.

  • Ophthalmology Physician
  • Holmdel, NJ
National Provider Identifier
1750491015
Registry record updated Jan 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
25MA07128400 Issued in NJ
Practice address
719 N Beers St
Suite 1B
Holmdel, NJ 07733-1522
Phone
(732) 264-6464
Fax
(732) 264-5114
NPI assigned
Aug 30, 2006
Last updated
Jan 16, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 25MA07128400 NJ Primary

Addresses

Primary practice location

719 N Beers St
Suite 1B
Holmdel, NJ 07733-1522

Mailing address

719 N Beers St
Suite 1B
Holmdel, NJ 07733-1522
Phone (732) 264-6464

Other identifiers 1

IdentifierTypeStateIssuer
8423105MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110314000919 NJ Practitioner - Ophthalmology 8921093857 Reassigns benefits to 1 organization
I20140319000101 NY Practitioner - OphthalmologyPractitioner - Internal Medicine 8921093857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bayshore Ophthalmology, LLCGroup PAC ID 1355336280, 5 clinicians

Practice addresses (Care Compare)

719 N Beers St
Suite 1B
Holmdel, NJ 07733-1523
Phone (732) 264-6464

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery231

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA07128400NJMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bayshore Ophthalmology, LLC Ophthalmology CurrentSince Jul 1, 2003 Accepting new patients
Bayshore Ophthalmology, LLC Ophthalmology CurrentSince Jul 1, 2003 Accepting new patients
Coney Island Medical Practice Plan, P.C. CurrentSince Jan 7, 2014 Accepting new patients
Hudson Valley Eye Doctor of Optometry PC PastSince May 29, 2018 Accepting new patients
Highland Ophthalmology Associates LLC Ophthalmology PastSince Jan 20, 2000 Accepting new patients
University Group Medical Associates, P.C Ophthalmology Past Accepting new patients

Locations

719 N Beers St
Ste 1B
Holmdel, NJ 07733
Phone (732) 264-6464

205 Bridge St
Bldg D
Metuchen, NJ 08840
Phone (201) 952-6520

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

Interoperability endpoints

  • Direct secure messaging: surekha.collur@bayshore.direct.eyemdemr.com

Organizations & group practices 6

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200441600000",
    "number": "1750491015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 N BEERS ST",
            "address_2": "SUITE 1B",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331522",
            "telephone_number": "732-264-6464",
            "fax_number": "732-264-5114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 N BEERS ST",
            "address_2": "SUITE 1B",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331522",
            "telephone_number": "732-264-6464",
            "fax_number": "732-264-5114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLUR",
        "first_name": "SUREKHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA07128400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8423105",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

Verify at the official NPI Registry.