Matthew A Kelleman, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OM00073100 Issued in NJ

Practice address

36 N Main St
Milltown, NJ 08850-1549

Phone

(732) 828-2246

Fax

(732) 374-3004

NPI assigned

Jun 28, 2006

Last updated

Jan 12, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Milltown Family VisionGroup PAC ID 3375026347, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Milltown Family Vision

  dba Milltown Vision

  • Optometrist
  • Milltown, NJ
  • NPI 1679464960
  Medicare reassignment Care Compare group NPD
• Milltown Vision Care

  • Optometrist
  • Milltown, NJ
  • NPI 1033386719
  NPD (past) Authorized official
• Milltown Vision Care

  • Optometrist
  • Milltown, NJ
  • NPI 1750834107
  Authorized official Same address or phone

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1801824032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 N MAIN ST",
            "city": "MILLTOWN",
            "state": "NJ",
            "postal_code": "088501549",
            "telephone_number": "732-828-2246",
            "fax_number": "732-374-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 N MAIN ST",
            "city": "MILLTOWN",
            "state": "NJ",
            "postal_code": "088501549",
            "telephone_number": "732-828-2246",
            "fax_number": "732-374-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEMAN",
        "first_name": "MATTHEW",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00434000",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OM00073100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Horizon Medical Supplies LLC
• Diane Jean Ivanov, LCSW
• Thomas Gerhard Jacoby, DMD
• Janine Essig LPC Lcadc LLC
• Joel R Kates, DPM
• Kiara Physical Therapy LLC (Advanced Care Physical Therapy)
• Elissa Kay Koplik, PH.D.
• Krishna Physical Therapy LLC
• Marian Kwon, PHARMD
• Esther Jieun Lee, PHARM.D

• Optometrist in Milltown, NJ
• Providers in Milltown, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.