Individual provider Active NPI

Amy E. W. Sumner, OD

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1063084101
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00706900 Issued in NJ
Practice address
1420 Walnut St Ste 600
Philadelphia, PA 19102-4005
Phone
(215) 735-6300
Fax
(215) 735-2244
NPI assigned
Jul 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003851 PA
Optometrist 152W00000X 27OA00706900 NJ Primary

Addresses

Primary practice location

1420 Walnut St Ste 600
Philadelphia, PA 19102-4005

Mailing address

2804 Memphis St
Philadelphia, PA 19134-4208
Phone (410) 920-9012

Other names 1

  • Amy E Wherry Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210928000312 NJ Practitioner - Optometry 9638573199 Reassigns benefits to 1 organization
I20220321000262 PA Practitioner - Optometry 9638573199 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resident Eye Care Associates LLCGroup PAC ID 1153310180, 14 clinicians

Practice addresses (Care Compare)

2125 Fairview Ave
Easton, PA 18042-3813
Phone (201) 797-2747

4 -14 Saddle River Rd
Suite 202
Fair Lawn, NJ 07410-5624
Phone (201) 797-2747

4 -14 Saddle River Rd
Suite 202
Fair Lawn, NJ 07410-5632

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sight Services P.C. Optometrist CurrentSince May 1, 2023 Accepting new patients
Resident Eye Care Associates, LLC Optometrist CurrentSince Sep 11, 2023 Accepting new patients
Visionary Eye Care Associates LLC Optometrist CurrentSince Jul 1, 2021 Accepting new patients
Moa Medical Practices PC Optometrist PastSince Dec 1, 2021 Accepting new patients

Locations

650 Garden Park Blvd
Cherry Hill, NJ 08002
Phone (856) 406-7445

4-14 Saddle River Rd
Ste 202
Fair Lawn, NJ 07410
Phone (718) 980-7700

100 Centerton Rd
Mount Laurel, NJ 08054
Phone (856) 359-3650

267 Broadway
Fl 2
Brooklyn, NY 11211
Phone (716) 912-5877

2125 Fairview Ave
Easton, PA 18042
Phone (610) 258-2801

845 Germantown Pike
Plymouth Mtng, PA 19462
Phone (610) 279-7300

100 Edella Rd
South Abington Township, PA 18411
Phone (570) 586-1002

Organizations & group practices 4

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": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1063084101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 MEMPHIS ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191344208",
            "telephone_number": "410-920-9012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 WALNUT ST STE 600",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024005",
            "telephone_number": "215-735-6300",
            "fax_number": "215-735-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMNER",
        "first_name": "AMY",
        "middle_name": "E. W.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-16",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003851",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00706900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "WHERRY",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.