Individual provider Active NPI

Priyam Patel, OD

  • Optometrist
  • East Windsor, NJ
National Provider Identifier
1871872192
Registry record updated Dec 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA0063300 Issued in NJ
Practice address
104 Hickory Corner Rd
Suite 203
East Windsor, NJ 08520-2460
Phone
(609) 308-2850
NPI assigned
Aug 4, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 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 27OA0063300 NJ Primary

Addresses

Primary practice location

104 Hickory Corner Rd
Suite 203
East Windsor, NJ 08520-2460

Mailing address

104 Hickory Corner Rd
Suite 203
East Windsor, NJ 08520-2460
Phone (609) 308-2850

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
I20111114000703 NJ Practitioner - Optometry 0244404010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Windsor Eyecare, LLCGroup PAC ID 2961627526, 2 clinicians

Practice addresses (Care Compare)

104 Hickory Corner Rd
Suite 203
East Windsor, NJ 08520-2460
Phone (609) 308-2850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA0063300NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye of the Tiger, LLC Optometrist Current Accepting new patients
East Windsor Eyecare, LLC Optometrist CurrentSince Mar 25, 2014 Accepting new patients

Locations

104 Hickory Corner Rd
Ste 203
East Windsor, NJ 08520
Phone (609) 308-2850

104 Hickory Corner Rd
East Windsor, NJ 08520
Phone (609) 308-2850

3100 Quakerbridge Rd
Trenton, NJ 08619
Phone (609) 584-6640

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1312416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387756800000",
    "number": "1871872192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 HICKORY CORNER RD",
            "address_2": "SUITE 203",
            "city": "EAST WINDSOR",
            "state": "NJ",
            "postal_code": "085202460",
            "telephone_number": "609-308-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 HICKORY CORNER RD",
            "address_2": "SUITE 203",
            "city": "EAST WINDSOR",
            "state": "NJ",
            "postal_code": "085202460",
            "telephone_number": "609-308-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRIYAM",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-04",
        "last_updated": "2013-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA0063300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Windsor, NJ

Sources for this page

Verify at the official NPI Registry.