Lisa Ann Buraks, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG000739 Issued in PA

Practice address

1601 S Columbus Blvd
Walmart Vision Center
Philadelphia, PA 19148-1402

Phone

(215) 389-5814

Fax

(215) 755-6561

NPI assigned

Nov 6, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eyelash Vision, LLC

  dba Pearle Vision

  • Optician
  • Collegeville, PA
  • NPI 1639478035
  Medicare reassignment NPD
• Philadelphia Eyecare Professionals, LLC

  • Optometrist
  • Philadelphia, PA
  • NPI 1598068504
  Authorized official Same address or phone
• Pine River Group LLC

  • Optometrist
  • Collegeville, PA
  • NPI 1912847500
  NPD
• Wal-Mart Stores East, LP

  dba Walmart Pharmacy 10-2229

  • Pharmacy
  • Apollo Beach, FL
  • NPI 1437027208
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302480000000",
    "number": "1033288022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WEATHERWOOD LN",
            "city": "RADNOR",
            "state": "PA",
            "postal_code": "190872724",
            "telephone_number": "215-530-3112",
            "fax_number": "215-755-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 S COLUMBUS BLVD",
            "address_2": "WALMART VISION CENTER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191481402",
            "telephone_number": "215-389-5814",
            "fax_number": "215-755-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURAKS",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2011-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015391140003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Gantt Buonomo, CRNP
• Saranya Buppajarntham, M.D.
• Mark Bur, PSYD
• Ilene Heidi Burach, M.D.
• Maanasi Burak, M.D.
• Gonca Gul Bural, MD
• Christopher P Burba, OTR/L
• Lynn Marie Burbank, N.P.
• Nina Burbure, MD
• Amanda Burch

• Optometrist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.