CHARLES M. CUMMINS O.D.
NPI 1396702296
Optometrist in Bloomfield, NJ
NPI Status: Active since April 26, 2006
Contact Information
1255 BROAD ST
BLOOMFIELD, NJ
ZIP 07003
Phone: (973) 338-7575
Fax: (973) 338-5158
- Individual
- Male
- Optometrist
- Accepts Insurance
- PECOS Enrolled
About CHARLES CUMMINS
This page provides the complete NPI Profile along with additional information for Charles Cummins, a provider established in Bloomfield, New Jersey with a medical specialization in Optometrist. The healthcare provider is registered in the NPI registry with number 1396702296 assigned on April 2006. The practitioner's primary taxonomy code is 152W00000X with license number 270A00371900 (NJ). The provider is registered as an individual and his NPI record was last updated 18 years ago.
- NPI
- 1396702296
- Provider Name
- CHARLES M. CUMMINS O.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1255 BROAD ST BLOOMFIELD, NJ 07003
- Location Phone
- (973) 338-7575
- Location Fax
- (973) 338-5158
- Mailing Address
- 11103 WEST AVE SUITE 6 SAN ANTONIO, TX 78213
- Mailing Phone
- (210) 524-6663
- Mailing Fax
- (973) 338-5158
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 04-26-2006
- Last Update Date
- 07-08-2007
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Optometrist
- Taxonomy Code
- 152W00000X
- Type
- Eye and Vision Services Providers
- License No.
- 270A00371900
- License State
- NJ
- Taxonomy Description
- Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Silver - HMO
- Elite Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Blue Max 70/50 $6700 - PPO
- Blue Max 90/70 $1500 - PPO
- Blue Max Copay (PCP, Specialist, Urgent Care) 50/50 $3300 - PPO
- Blue Max Copay (PCP, Specialist, Urgent Care) 50/50 $7500 Standardized Plan - PPO
- Blue Max Copay (PCP, Specialist, Urgent Care) 60/40 $5000 Standardized Plan - PPO
- Blue Max Copay (PCP, Specialist, Urgent Care) 75/55 $1500 Standardized Plan - PPO
- Blue Saver 60/40 $6100 - PPO
- Blue Saver 90/70 $3200 - PPO
- BlueSelect Bronze Basic - PPO
- BlueSelect Bronze Core - PPO
- BlueSelect Expanded Bronze Standard without Kid's Dental - PPO
- BlueSelect Gold Core - PPO
- BlueSelect Gold HealthPlus - PPO
- BlueSelect Gold Standard without Kid's Dental - PPO
- BlueSelect Silver Classic - PPO
- BlueSelect Silver Classic without Kid's Dental - PPO
- BlueSelect Silver HealthPlus - PPO
- BlueSelect Silver HealthPlus without Kid's Dental - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 602129 | MEDICARE ID-TYPE UNSPECIFIED (04) | NJ | |
| 1779605 | MEDICAID (05) | NJ | |
| U01587 | MEDICARE UPIN (02) | NJ |
Medicare Participation & PECOS Enrollment Status
Charles Cummins is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: No
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 07003 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $144.86
- Minimum New Patient Price $63.84
- Maximum New Patient Price $190.92
- Average New Patient Copayment $36.21
- Minimum New Patient Copayment $15.96
- Maximum New Patient Copayment $47.73
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $79.09
- Minimum Established Patient Price $20.97
- Maximum Established Patient Price $155.92
- Average Established Patient Copayment $19.77
- Minimum Established Patient Copayment $5.24
- Maximum Established Patient Copayment $38.98
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Reviews for CHARLES M. CUMMINS O.D.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 9 | 6 | 7 | 0 | 2 | 2 | 9 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 18 | 6 | 14 | 0 | 4 | 2 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 8 + 6 + 1 + 4 + 0 + 4 + 2 + 1 + 8 + 24 = 64 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 64 = 6 | 6 | ||||||||
The NPI number 1396702296 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1619045978 | SANDRA ROBBINS OD Individual | Optometrist | 1255 BROAD ST BLOOMFIELD, NJ 07003 (973) 338-7575 |
| 1649338328 | DENISE FURES OD Individual | Optometrist | 1255 BROAD ST BLOOMFIELD, NJ 07003 (973) 338-7575 |
| 1083836944 | MARIA TURIZO MD Individual | Pediatrics | 1255 BROAD ST SUITE 105 BLOOMFIELD, NJ 07003 (973) 233-5494 |
| 1720271760 | NITI MISTRY OD Individual | Optometrist | 1255 BROAD ST BLOOMFIELD, NJ 07003 (973) 338-7575 |
| 1134367915 | MRS. GINA M BARRA MA, LPC Individual | Counselor (Professional) | 1255 BROAD ST SUITE 204 BLOOMFIELD, NJ 07003 (973) 771-9000 |
| 1043445323 | MR. JOSE PEREZ MA, LMFT Individual | Counselor (Mental Health) | 1255 BROAD ST SUITE 204 BLOOMFIELD, NJ 07003 (973) 771-9000 |
| 1093038689 | BLOOMFIELD SPINE & REHABILITATION Organization | Chiropractor (Rehabilitation) | 1255 BROAD ST SUITE 207 BLOOMFIELD, NJ 07003 (973) 233-7104 |
| 1730560962 | AFFORDABLE CARE EYE PHYSICIAN NETWORK Organization | Ophthalmology | 1255 BROAD ST STE 104 BLOOMFIELD, NJ 07003 (973) 707-5632 |
| 1437535374 | DR. AMANDA BRITTANY CIELESZ AU.D. Individual | Audiologist | 1255 BROAD ST SUITE 206 BLOOMFIELD, NJ 07003 (973) 338-0309 |
| 1518375617 | KEVIN DISHON PT, DPT Individual | Physical Therapist | 1255 BROAD ST SUITE 207 BLOOMFIELD, NJ 07003 (973) 893-9300 |
| 1154981140 | ANURADHA P RANA OD Individual | Optometrist | 1255 BROAD ST BLOOMFIELD, NJ 07003 (973) 338-7575 |
| 1275088197 | DR. SHRABANTI GOSWAMI O.D. Individual | Optometrist | 1255 BROAD ST BLOOMFIELD, NJ 07003 (973) 338-7575 |
| 1194354126 | TATIANA DEA APN Individual | Nurse Practitioner (Family) | 1255 BROAD ST BLOOMFIELD, NJ 07003 (201) 833-9500 |
| 1376757351 | PROSPECT REHABILATATION SERVICES, INC. Organization | Clinic/Center (Physical Therapy) | 1255 BROAD ST BLOOMFIELD, NJ 07003 (973) 893-9300 |
| 1780898759 | AACCURATE PHYSICAL THERAPY, INC. Organization | Clinic/Center (Physical Therapy) | 1255 BROAD ST BLOOMFIELD, NJ 07003 (973) 893-9300 |
| 1578529707 | CHARLES M CUMMINS OD PA Organization | Eyewear Supplier | 1255 BROAD ST BLOOMFIELD, NJ 07003 (973) 338-7575 |
| 1003430612 | FRANCESCA A LUBRANO PA-C Individual | Physician Assistant | 1255 BROAD ST BLOOMFIELD, NJ 07003 (201) 833-9500 |
| 1285642470 | DR. PATRICK M. HIGGINS MD Individual | Ophthalmology | 1255 BROAD ST STE 104 BLOOMFIELD, NJ 07003 (973) 707-5632 |
| 1578096459 | RANDY STEVEN QUESADA M.D. Individual | Anesthesiology | 1255 BROAD ST BLOOMFIELD, NJ 07003 (973) 842-2150 |
| 1023017357 | LAUREN ANGIOLETTI M.D. Individual | Ophthalmology | 1255 BROAD ST STE 104 BLOOMFIELD, NJ 07003 (973) 707-5632 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1396702296, enumerated in the NPI registry as an "individual" on April 26, 2006
The provider is located at 1255 Broad St Bloomfield, Nj 07003 and the phone number is (973) 338-7575
The provider's speciality is Optometrist with taxonomy code 152W00000X
The provider might be accepting Accepts: Ambetter Health, Ambetter Health of Delaware, Blue. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
Medicare beneficiaries should expect a typical cost of $144.86 with an average copayment of $36.21 for new patient appointments. Established patients should expect a typical charge of $79.09 and an average copayment of 19.77. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on April 26, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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