NPIMap

Organization Active NPI

Residency Eye Care

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1053671016
Registry record updated Sep 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OET008924 Issued in PA
Legal business name
RESIDENCY EYE CARE
Practice address
6331 Stenton Ave
Philadelphia, PA 19138-1129
Phone
(215) 548-5949
NPI assigned
May 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2015

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

Authorized official

Name
Dr. Chelise Firmin, ODNPI 1245235035
Title
Owner
Phone
(267) 259-9620

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OET008924 PA Primary

Addresses

Primary practice location

6331 Stenton Ave
Philadelphia, PA 19138-1129

Mailing address

6331 Stenton Ave
Philadelphia, PA 19138-1129
Phone (215) 548-5949

Other names 1

  • Optima Vision Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151228000220 PA Part B Supplier - Clinic/Group Practice 4688975253 Receives reassigned benefits from 1 practitioner
Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory

Locations

6331 Stenton Ave
Philadelphia, PA 19138
Phone (215) 548-5949

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441065600000",
    "number": "1053671016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6331 STENTON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191381129",
            "telephone_number": "215-548-5949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6331 STENTON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191381129",
            "telephone_number": "215-548-5949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENCY EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-24",
        "last_updated": "2015-09-01",
        "status": "A",
        "authorized_official_last_name": "FIRMIN",
        "authorized_official_first_name": "CHELISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-259-9620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OET008924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optima Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; 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.