NPIMap

Organization Active NPI

Regional Eye Associates, Inc

  • Ophthalmology Physician
  • Weston, WV
National Provider Identifier
1003446444
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
REGIONAL EYE ASSOCIATES, INC
Practice address
402 Medical Park Dr Ste 100
Weston, WV 26452-1678
Phone
(304) 406-6555
NPI assigned
Jan 24, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Authorized official

Name
Edgar C GamponiaNPI 1053487736
Title
Managing Partner
Phone
(304) 598-3301

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 Primary

Addresses

Primary practice location

402 Medical Park Dr Ste 100
Weston, WV 26452-1678

Mailing address

1255 Pineview Dr
Morgantown, WV 26505-2738
Phone (304) 598-3301

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040211001115 WV Part B Supplier - Clinic/Group Practice 1456255876 Receives reassigned benefits from 18 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bridgeport, WV; Morgantown, WV; Weston, WV

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Surgical Eye Ctr of Mor7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

888 Memorial Dr
Oakland, MD 21550
Phone (301) 334-1016

300 Davisson Run Rd
Ste 204
Clarksburg, WV 26301
Phone (304) 624-5616

10 Valley St
Ste 201
Petersburg, WV 26847
Phone (304) 257-4555

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1003446444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 PINEVIEW DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265052738",
            "telephone_number": "304-598-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 MEDICAL PARK DR STE 100",
            "city": "WESTON",
            "state": "WV",
            "postal_code": "264521678",
            "telephone_number": "304-406-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL EYE ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-24",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "GAMPONIA",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "304-598-3301"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.