Individual provider Active NPI

Christine Annette Zlupko, O.D.

  • Optometrist
  • Port Matilda, PA
National Provider Identifier
1043322654
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001228 Issued in PA
Practice address
650 Grays Woods Blvd
Ste 120
Port Matilda, PA 16870-7111
Phone
(814) 272-0262
Fax
(814) 272-1501
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG001228 PA Primary

Addresses

Primary practice location

650 Grays Woods Blvd
Ste 120
Port Matilda, PA 16870-7111

Mailing address

650 Grays Woods Blvd
Ste 120
Port Matilda, PA 16870-7111
Phone (814) 272-0262

Other identifiers 4

IdentifierTypeStateIssuer
127135OtherPAHIGHMARK INDIVIDUAL ID
50042775OtherPACAPITAL BLUE CROSS
1024375140001MedicaidPA
25126OtherHEALTH AMERICA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100323000230 PA Practitioner - Optometry 3971638420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Restore Eye Care, P.C.Group PAC ID 7719909829, 2 clinicians

Practice addresses (Care Compare)

650 Grays Woods Blvd
Suite 120
Port Matilda, PA 16870-7142
Phone (814) 272-0262

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG001228PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Restore Eye Care, P.C. Optometrist CurrentSince Jan 9, 2010 Accepting new patients

Locations

650 Grays Woods Blvd
Ste 120
Port Matilda, PA 16870
Phone (814) 272-0262

100 Oakwood Ave
Ste 300
State College, PA 16803
Phone (814) 272-0262

Interoperability endpoints

  • Direct secure messaging: czlupko@sepicheyecare.eyefinitydirect.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1043322654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 GRAYS WOODS BLVD",
            "address_2": "STE 120",
            "city": "PORT MATILDA",
            "state": "PA",
            "postal_code": "168707111",
            "telephone_number": "814-272-0262",
            "fax_number": "814-272-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 GRAYS WOODS BLVD",
            "address_2": "STE 120",
            "city": "PORT MATILDA",
            "state": "PA",
            "postal_code": "168707111",
            "telephone_number": "814-272-0262",
            "fax_number": "814-272-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZLUPKO",
        "first_name": "CHRISTINE",
        "middle_name": "ANNETTE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK INDIVIDUAL ID",
            "identifier": "127135",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50042775",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024375140001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "25126",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Matilda, PA

Sources for this page

Verify at the official NPI Registry.