Individual provider Active NPI

Christopher Brien Malloy, O.D.

  • Optometrist
  • Brick, NJ
National Provider Identifier
1922186246
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00529400 Issued in NJ
Practice address
359 Brick Blvd
Brick, NJ 08723-6010
Phone
(732) 920-1330
NPI assigned
Nov 2, 2006
Last updated
Nov 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5294 NJ
Optometrist 152W00000X 27OA00529400 NJ Primary

Addresses

Primary practice location

359 Brick Blvd
Brick, NJ 08723-6010

Mailing address

PO Box 2089444
Dallas, TX 75320-6010
Phone (636) 200-4393

Other practice location 1

1001 Route 70 Unit B1
Manchester, NJ 08759-5804
Phone (732) 657-1400

Other identifiers 1

IdentifierTypeStateIssuer
6247105MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5294NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optometric Physicians of Middletown PA Optometrist CurrentSince Apr 16, 2021 Accepting new patients
Optometric Physicians of Middletown PA Optometrist CurrentSince Apr 16, 2021 Accepting new patients
Manchester Brick Vision Center 2 Optometrist PastSince Feb 19, 2001 Accepting new patients

Locations

359 Brick Blvd
Brick, NJ 08723
Phone (732) 920-1330

1001 Route 70
Unit B1
Manchester, NJ 08759
Phone (732) 657-1400

786 State Route 35
Middletown, NJ 07748
Phone (732) 671-7300

35 Monmouth St
Red Bank, NJ 07701
Phone (732) 530-5151

Interoperability endpoints

  • Direct secure messaging: eyesfirst@eyesfirstbrick.eyeclinicdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1922186246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2089444",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753206010",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359 BRICK BLVD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087236010",
            "telephone_number": "732-920-1330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Route 70 Unit B1",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NJ",
            "postal_code": "087595804",
            "country_code": "US",
            "telephone_number": "732-657-1400",
            "fax_number": "732-657-1402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLOY",
        "first_name": "CHRISTOPHER",
        "middle_name": "BRIEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "5294",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00529400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6247105",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.