Individual provider Active NPI

Chauncey Brown Jr., D.O.

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1043765050
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003215 Issued in PA
Practice address
6001 N 5TH Street
Office
Philadelphia, PA 19120-1825
Phone
(267) 335-2647
Fax
(267) 535-3086
NPI assigned
Aug 19, 2016
Last updated
Oct 29, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003215 PA Primary

Addresses

Primary practice location

6001 N 5TH Street
Office
Philadelphia, PA 19120-1825

Mailing address

6001 N 5TH Street
Office
Philadelphia, PA 19120-1825
Phone (267) 335-2647

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
I20180424002935 PA Practitioner - Optometry 1153684238 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

30 S Macdade Blvd
Glenolden, PA 19036-1725
Phone (610) 586-0651

6001 N 5TH St
Office
Philadelphia, PA 19120-1825
Phone (267) 335-2647

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OEG003215PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Chauncey Eyecare Associates PLLC Optometrist CurrentSince Oct 29, 2019 Accepting new patients
Chauncey Eye Group LLC Optometrist CurrentSince Mar 17, 2018 Accepting new patients

Locations

30 S Macdade Blvd
Glenolden, PA 19036
Phone (610) 586-0651

6001 N 5th St
Ofc
Philadelphia, PA 19120
Phone (267) 335-2647

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1043765050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 N 5TH STREET",
            "address_2": "OFFICE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191201825",
            "telephone_number": "267-335-2647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 N 5TH STREET",
            "address_2": "OFFICE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191201825",
            "telephone_number": "267-335-2647",
            "fax_number": "267-535-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CHAUNCEY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-19",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.