Individual provider Active NPI

Kyle N Hrymack, OD

  • Optometrist
  • Fair Lawn, NJ
National Provider Identifier
1750646915
Registry record updated Dec 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00639100 Issued in NJ
Practice address
4-14 Saddle River Rd
Fair Lawn, NJ 07410-5632
Phone
(201) 797-2747
Fax
(201) 797-5809
NPI assigned
Jul 12, 2012
Last updated
Dec 4, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00639100 NJ Primary

Addresses

Primary practice location

4-14 Saddle River Rd
Fair Lawn, NJ 07410-5632

Mailing address

319 Madison CT
Brick, NJ 08724-1628
Phone (732) 598-5763

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20121023000447 NJ Practitioner - Optometry 9931359254 Reassigns benefits to 2 organizations
I20140918001277 PA Practitioner - Optometry 9931359254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
25.83 of 100Reported as individual
Quality
31.67
Improvement activities
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00639100NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Resident Eye Care Associates, LLC Optometrist CurrentSince Aug 1, 2013 Accepting new patients
Home Vision Group LLC Optometrist CurrentSince Feb 5, 2014 Accepting new patients

Locations

4-14 Saddle River Rd
Fair Lawn, NJ 07410
Phone (201) 791-4002

4-14 Saddle River Rd
Ste 202
Fair Lawn, NJ 07410
Phone (718) 980-7700

2125 Fairview Ave
Easton, PA 18042
Phone (610) 258-2801

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1750646915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 MADISON CT",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087241628",
            "telephone_number": "732-598-5763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4-14 SADDLE RIVER RD",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074105632",
            "telephone_number": "201-797-2747",
            "fax_number": "201-797-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HRYMACK",
        "first_name": "KYLE",
        "middle_name": "N",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-12",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00639100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

Verify at the official NPI Registry.