NPIMap

Individual provider Active NPI

Darrell Evans, O.D.

  • Optometrist
  • Kingston, PA
National Provider Identifier
1033149331
Registry record updated Feb 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000726 Issued in PA
Practice address
703 Rutter Ave
Kingston, PA 18704-4801
Phone
(570) 288-7405
Fax
(570) 288-7406
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000726 PA Primary

Addresses

Primary practice location

703 Rutter Ave
Kingston, PA 18704-4801

Mailing address

703 Rutter Ave
Kingston, PA 18704-4801
Phone (570) 288-7405

Other identifiers 1

IdentifierTypeStateIssuer
04102638MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100622000565 PA Practitioner - Optometry 5799816674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Innovation Centers of Pennsylvania LLC 86 clinicians

Practice addresses (Care Compare)

703 Rutter Ave
Kingston, PA 18704-4801
Phone (570) 288-7405

Merit-based Incentive Payment System (MIPS)

Final score
85.08 of 100Reported as group
Quality
85.29
Promoting interoperability
100
Improvement activities
40
Cost
64.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Innovation Centers of Pennsylvania LLC Optometrist Current Accepting new patients
Vision Innovation Centers of Pennsylvania LLC Optometrist CurrentSince Jan 1, 2020 Accepting new patients
Vision Innovation Centers of Pennsylvania, LLC Optometrist CurrentSince Jan 1, 2020 Accepting new patients
Vision Innovation Centers of Pennsylvania LLC Optometrist Past Accepting new patients

Locations

2661 Riva Rd
Ste 1030
Annapolis, MD 21401

40 Dallas Village Shopping Ctr
Dallas, PA 18612
Phone (570) 674-9001

1318 Eisenhower Blvd
Johnstown, PA 15904
Phone (814) 266-2027

120 Main St
Johnstown, PA 15901
Phone (814) 536-5343

703 Rutter Ave
Kingston, PA 18704
Phone (570) 288-7405

170 Boston Ave
West Pittston, PA 18643
Phone (570) 602-1010

679 Kidder St
Ste A
Wilkes Barre Township, PA 18702
Phone (570) 824-5715

Interoperability endpoints

  • Direct secure messaging: devans@vip.emadirect.md

Organizations & group practices 21

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392940800000",
    "number": "1033149331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 RUTTER AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187044801",
            "telephone_number": "570-288-7405",
            "fax_number": "570-288-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 RUTTER AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187044801",
            "telephone_number": "570-288-7405",
            "fax_number": "570-288-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "DARRELL",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2014-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04102638",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, PA

Sources for this page

Verify at the official NPI Registry.