Individual provider Active NPI

Gustie Christopher, O.D

  • Optometrist
  • East Havover, NJ
National Provider Identifier
1790161602
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
270800662000 Issued in NJ
Practice address
154 Route 10 West
Unit 4B
East Havover, NJ 07936-2107
Phone
(973) 887-0216
NPI assigned
Aug 3, 2015
Last updated
Aug 3, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 270800662000 NJ Primary

Addresses

Primary practice location

154 Route 10 West
Unit 4B
East Havover, NJ 07936-2107

Mailing address

5 Lawrence St
PH 32
Bloomfield, NJ 07003-4631
Phone (305) 879-9881

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
I20150916002737 NJ Practitioner - Optometry 9133436579 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Totowa Eyecare LLCGroup PAC ID 4981084266, 3 clinicians

Practice addresses (Care Compare)

169 Union Blvd
Totowa, NJ 07512-2603
Phone (973) 942-4221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
270800662000NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverdale Vision Care, P.a. Optometrist CurrentSince Aug 6, 2015 Accepting new patients
TML Vision Care, LLC Optometrist CurrentSince Aug 6, 2015 Accepting new patients
Totowa Eyecare LLC Optometrist CurrentSince Jun 27, 2022 Accepting new patients
NJ Vision Care LLC Optometrist Past Accepting new patients

Locations

154 State Route 10
Unit 4B
East Hanover, NJ 07936
Phone (973) 887-0216

92 State Rt 23
Ste E
Riverdale, NJ 07457
Phone (973) 248-0060

169 Union Blvd
Totowa, NJ 07512
Phone (973) 904-9909

Organizations & group practices 4

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": "1438560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1790161602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 LAWRENCE ST",
            "address_2": "PH 32",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034631",
            "telephone_number": "305-879-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 ROUTE 10 WEST",
            "address_2": "UNIT 4B",
            "city": "EAST HAVOVER",
            "state": "NJ",
            "postal_code": "079362107",
            "telephone_number": "973-887-0216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTOPHER",
        "first_name": "GUSTIE",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-03",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "270800662000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.