Individual provider Active NPI

Isaac Bak, O.D.

  • Optometrist
  • Hamilton, NJ
National Provider Identifier
1821168758
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00478100 Issued in NJ
Practice address
1750 Nottingham Way
Hamilton, NJ 08619-3551
Phone
(609) 734-7572
Fax
(609) 734-8403
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00478100 NJ Primary

Addresses

Primary practice location

1750 Nottingham Way
Hamilton, NJ 08619-3551

Mailing address

849 Edison Ave
Philadelphia, PA 19116-1240
Phone (215) 688-1478

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
I20120209000097 NJ Practitioner - Optometry 8325205974 Practice locations: Hamilton, NJ

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1750 Nottingham Way
Hamilton, NJ 08619-3551
Phone (609) 734-7572

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00478100NJMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1821168758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 EDISON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191161240",
            "telephone_number": "215-688-1478",
            "fax_number": "609-734-8403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 NOTTINGHAM WAY",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086193551",
            "telephone_number": "609-734-7572",
            "fax_number": "609-734-8403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAK",
        "first_name": "ISAAC",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00478100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, NJ

Sources for this page

Verify at the official NPI Registry.