NPIMap

Organization Active NPI

Laurel Eye Clinic

  • Optometrist
  • Brookville, PA
National Provider Identifier
1003878729
Registry record updated Jun 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
LAUREL EYE CLINIC
Practice address
50 Waterford Pike
Brookville, PA 15825-2518
Phone
(814) 849-8344
Fax
(814) 849-7130
NPI assigned
Apr 6, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Louis D Nichamin, M.D.
Title
Managing Partner
Phone
(814) 849-8344

Other NPIs on the same Medicare enrollment 1

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

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040415000936 PA Part B Supplier - Clinic/Group Practice 9537061692 Receives reassigned benefits from 14 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Seneca, PA; New Bethlehem, PA; Mercer, PA; Grove City, PA; Du Bois, PA; Duncansville, PA; Brookville, PA; Clearfield, PA

National Provider Directory

National Provider Directory
Tax ID family
Shirley E Ruth OD9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

50 Waterford Pike
Brookville, PA 15825-2518

Mailing address

50 Waterford Pike
Brookville, PA 15825-2518
Phone (814) 849-8344

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1007384840028MedicaidPA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 2, 2009.

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243900800000",
    "number": "1003878729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 WATERFORD PIKE",
            "city": "BROOKVILLE",
            "state": "PA",
            "postal_code": "158252518",
            "telephone_number": "814-849-8344",
            "fax_number": "814-849-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 WATERFORD PIKE",
            "city": "BROOKVILLE",
            "state": "PA",
            "postal_code": "158252518",
            "telephone_number": "814-849-8344",
            "fax_number": "814-849-7130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL EYE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2009-06-02",
        "status": "A",
        "authorized_official_last_name": "NICHAMIN",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "814-849-8344",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007384840028",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; 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.