NPIMap

Organization Active NPI

Barry N. Wasserman, MD LLC

  • Ophthalmology Physician
  • Princeton, NJ
National Provider Identifier
1962458836
Registry record updated May 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
25MA06022300 Issued in NJ
Legal business name
BARRY N. WASSERMAN, MD LLC
Practice address
100 Canal Pointe Blvd
Suite 112
Princeton, NJ 08540-7063
Phone
(609) 243-8711
NPI assigned
May 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2014

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

Authorized official

Name
Dr. Barry N Wasserman, M.D.NPI 1659378248
Title
Principal
Phone
(609) 243-8711

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 25MA06022300 NJ Primary

Addresses

Primary practice location

100 Canal Pointe Blvd
Suite 112
Princeton, NJ 08540-7063

Mailing address

100 Canal Pointe Blvd
Suite 112
Princeton, NJ 08540-7063
Phone (609) 243-8711

Other identifiers 2

IdentifierTypeStateIssuer
8170801MedicaidNJ
01652265MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080523000194 NJ Part B Supplier - Clinic/Group Practice 1850460312 Receives reassigned benefits from 2 practitioners
Practice locations: Lawrenceville, NJ

National Provider Directory

National Provider Directory

Locations

2999 Princeton Pike
Ste 1
Lawrenceville, NJ 08648
Phone (609) 243-8711

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399939200000",
    "number": "1962458836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CANAL POINTE BLVD",
            "address_2": "SUITE 112",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085407063",
            "telephone_number": "609-243-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CANAL POINTE BLVD",
            "address_2": "SUITE 112",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085407063",
            "telephone_number": "609-243-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARRY N. WASSERMAN, MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2014-05-13",
        "status": "A",
        "authorized_official_last_name": "WASSERMAN",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "609-243-8711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA06022300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8170801",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01652265",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.