Individual provider Active NPI

Hanna Haejo Han, O.D.

  • Optometrist
  • Palisades Park, NJ
National Provider Identifier
1972815090
Registry record updated Mar 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
270A00626500 Issued in NJ
Practice address
540 Bergen Blvd
Palisades Park, NJ 07650-2322
Phone
(201) 461-3970
NPI assigned
Jul 6, 2010
Last updated
Mar 31, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 270A00626500 NJ Primary
Optometrist 152W00000X TUV007582-1 NY

Addresses

Primary practice location

540 Bergen Blvd
Palisades Park, NJ 07650-2322

Mailing address

525 3Rd St
Palisades Park, NJ 07650-1803

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
I20111107000188 NJ Practitioner - Optometry 1658544747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charles M Cummins, OD, PAGroup PAC ID 0446246995, 24 clinicians

Practice addresses (Care Compare)

501 Route 17 S
Paramus, NJ 07652-3000
Phone (201) 265-9400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
270A00626500NJMDOptometrist
TUV007582-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Charles M Cummins, OD, PA Optometrist CurrentSince Jun 6, 2018 Accepting new patients
Charles M. Cummins, OD., PA Optometrist CurrentSince Jun 6, 2018 Accepting new patients

Locations

802 Bayonne Crossing Way
Bayonne, NJ 07002
Phone (201) 858-5615

1255 Broad St
Bloomfield, NJ 07003
Phone (973) 338-7575

588 Route 70
Ste 9
Brick, NJ 08723
Phone (732) 864-0755

251 Clifton Ave
Clifton, NJ 07011
Phone (973) 340-2300

501 N Route 17
Paramus, NJ 07652
Phone (201) 265-9400

500 Route 23
Ste 7
Pompton Plains, NJ 07444
Phone (973) 616-7171

255 US Highway 46
Totowa, NJ 07512
Phone (973) 785-8000

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, 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": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1972815090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 3RD ST",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076501803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 BERGEN BLVD",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076502322",
            "telephone_number": "201-461-3970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "HANNA HAEJO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-06",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "270A00626500",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007582-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palisades Park, NJ

Sources for this page

Verify at the official NPI Registry.