Active NPI
Christopher Brien Malloy, O.D.
- Optometrist
- Brick, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 27OA00529400
- Practice address
- 359 Brick Blvd
Brick, NJ 08723-6010 - Phone
- (732) 920-1330
- NPI assigned
- Nov 2, 2006
- Last updated
- Nov 18, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6247105 | Medicaid | NJ |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5294 | NJ | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optometric Physicians of Middletown PA | Optometrist | Current | Accepting new patients |
| Optometric Physicians of Middletown PA | Optometrist | Current | Accepting new patients |
| Manchester Brick Vision Center 2 | Optometrist | Past | 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
- 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.
-
dba Eyes First Vision Center
- Optometrist
- Middletown, NJ
- NPI 1457354037
-
dba Clarkson Eyecare
- Optometrist
- Toms River, NJ
- NPI 1801474960
-
- Optometrist
- Manchester, NJ
- NPI 1285789719
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.