NPIMap

Organization Active NPI

Aeg Pennsylvania Professional, Inc

Doing business as The Eyeglass Store

  • Optometrist
  • Monroeville, PA
National Provider Identifier
1003692617
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
AEG PENNSYLVANIA PROFESSIONAL, INC
Doing business as
The Eyeglass Store
Practice address
4156 William Penn Hwy
Monroeville, PA 15146-2602
Phone
(412) 372-8188
Fax
(314) 741-4947
NPI assigned
Sep 8, 2023
Last updated
Sep 8, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
AEG PENNSYLVANIA PROFESSIONAL, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Authorized official

Name
Melissa Allison
Title
Sr. Director RCM/MVC
Phone
(618) 462-9818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

4156 William Penn Hwy
Monroeville, PA 15146-2602

Mailing address

111 E 4TH St Ste 440
Alton, IL 62002-6206
Phone (618) 462-9818

Other names 1

  • The Eyeglass Store Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Aeg Pennsylvania Prof Inc29 organizations share this tax ID, including this one
Part of
Aeg Pennsylvania Prof Inc

Other organizations with this tax ID 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1694131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694131200000",
    "number": "1003692617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 4TH ST STE 440",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026206",
            "telephone_number": "618-462-9818",
            "fax_number": "314-741-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4156 WILLIAM PENN HWY",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462602",
            "telephone_number": "412-372-8188",
            "fax_number": "314-741-4947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEG PENNSYLVANIA PROFESSIONAL, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AEG PENNSYLVANIA PROFESSIONAL, INC",
        "enumeration_date": "2023-09-08",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A",
        "authorized_official_last_name": "ALLISON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "SR. DIRECTOR RCM/MVC",
        "authorized_official_telephone_number": "618-462-9818"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Eyeglass Store",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monroeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.