Active NPI
Paul Stephen Mazur, O.D.
- Optometrist
- Manasquan, NJ
National Provider Identifier
1801865050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OA04216
- Practice address
- 2516 Highway 35
Unit 102
Manasquan, NJ 08736-1926 - Phone
- (732) 223-8000
- Fax
- (732) 223-4010
- NPI assigned
- Mar 17, 2006
- Last updated
- Jan 16, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OA04216 | NJ | Primary |
Addresses
Primary practice location
2516 Highway 35
Unit 102
Manasquan, NJ 08736-1926
Mailing address
2516 Highway 35
Unit 102
Manasquan, NJ 08736-1926
Phone (732) 223-8000
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 691 | Other | SC | LICENSE |
| OA04216 | Other | NJ | LICENSE |
| 222523338 | Other | NJ | TAX ID |
| 4995201 | Medicaid | NJ |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041108000629 | NJ | Practitioner - Optometry | 8820051188 | Practice locations: Manasquan, NJ |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OA04216 | NJ | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358294400000",
"number": "1801865050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2516 HIGHWAY 35",
"address_2": "UNIT 102",
"city": "MANASQUAN",
"state": "NJ",
"postal_code": "087361926",
"telephone_number": "732-223-8000",
"fax_number": "732-223-4010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2516 HIGHWAY 35",
"address_2": "UNIT 102",
"city": "MANASQUAN",
"state": "NJ",
"postal_code": "087361926",
"telephone_number": "732-223-8000",
"fax_number": "732-223-4010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZUR",
"first_name": "PAUL",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-17",
"last_updated": "2013-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NJ",
"license": "OA04216",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "691",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "OA04216",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "222523338",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4995201",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manasquan, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.