Individual provider Active NPI

Sana Fasihuddin, OD

  • Optometrist
  • Bridgewater, NJ
National Provider Identifier
1912728940
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00732500 Issued in NJ
Practice address
329 Route 202/206
Bridgewater, NJ 08807-2442
Phone
(908) 685-1500
NPI assigned
Oct 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00732500 NJ Primary

Addresses

Primary practice location

329 Route 202/206
Bridgewater, NJ 08807-2442

Mailing address

329 Route 202/206
Bridgewater, NJ 08807-2442

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
I20250219001407 NJ Practitioner - Optometry 2769902931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ehg NJ Service LLCGroup PAC ID 9335556315, 19 clinicians

Practice addresses (Care Compare)

329 US Hwy 202/206
Bridgewater, NJ 08807-2442
Phone (908) 685-0794

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00732500NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ehg NJ Service LLC Optometrist CurrentSince Feb 15, 2025 Accepting new patients
The Optical Group of NJ LLC PastSince Oct 27, 2024 Accepting new patients
Main Street Clinic, LLC Past Accepting new patients

Locations

275 US Highway 22
Springfield, NJ 07081
Phone (973) 376-7900

1278 Hooper Ave
Toms River, NJ 08753
Phone (732) 505-0533

Organizations & group practices 3

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": "1729555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1912728940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 ROUTE 202/206",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 ROUTE 202/206",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072442",
            "telephone_number": "908-685-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASIHUDDIN",
        "first_name": "SANA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-22",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00732500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

Verify at the official NPI Registry.