Individual provider Active NPI

Brook T Kressley, O.D.

  • Optometrist
  • Sewickley, PA
National Provider Identifier
1003038316
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001852 Issued in PA
Practice address
400 Broad St
Suite 2020
Sewickley, PA 15143-1500
Phone
(412) 741-4610
Fax
(412) 741-8967
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG001852 PA Primary

Addresses

Primary practice location

400 Broad St
Suite 2020
Sewickley, PA 15143-1500

Mailing address

317 Polo Club Dr
Moon TWP, PA 15108-4709
Phone (765) 412-0246

Other identifiers 1

IdentifierTypeStateIssuer
OEG001852OtherPASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20070605000213 PA Practitioner - Optometry 0941308605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sewickley Eye Center, LTDGroup PAC ID 0345137105, 10 clinicians

Practice addresses (Care Compare)

400 Broad St
Suite 2020
Sewickley, PA 15143-1500
Phone (412) 741-4610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG001852PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sewickley Eye Center, LTD CurrentSince Sep 13, 2011 Accepting new patients

Locations

846 California Ave
Avalon, PA 15202
Phone (412) 741-4610

27 Heckel Rd
Ste 211
Mc Kees Rocks, PA 15136
Phone (412) 777-4300

95 Golfview Dr
#A
Monaca, PA 15061
Phone (724) 770-9000

400 Broad St
Ste 2020
Sewickley, PA 15143
Phone (412) 741-4610

Networks

  • devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8
  • devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
  • devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9

Organizations & group practices 1

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003038316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 POLO CLUB DR",
            "city": "MOON TWP",
            "state": "PA",
            "postal_code": "151084709",
            "telephone_number": "765-412-0246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BROAD ST",
            "address_2": "SUITE 2020",
            "city": "SEWICKLEY",
            "state": "PA",
            "postal_code": "151431500",
            "telephone_number": "412-741-4610",
            "fax_number": "412-741-8967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRESSLEY",
        "first_name": "BROOK",
        "middle_name": "T",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "OEG001852",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewickley, PA

Sources for this page

Verify at the official NPI Registry.