Organization Active NPI

Lawrenceville Vision Care, P.C.

  • Optometrist
  • Pittsburgh, PA
National Provider Identifier
1063524726
Registry record updated Oct 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000851 Issued in PA
Legal business name
LAWRENCEVILLE VISION CARE, P.C.
Practice address
4122 Butler St
Pittsburgh, PA 15201-3162
Phone
(412) 682-2339
Fax
(412) 682-2809
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2010

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

Authorized official

Name
Danielle K Staresinic, ODNPI 1790777498
Title
President
Phone
(412) 682-2339

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 OEG000851 PA Primary

Addresses

Primary practice location

4122 Butler St
Pittsburgh, PA 15201-3162

Mailing address

4122 Butler St
Pittsburgh, PA 15201-3162
Phone (412) 682-2339

Other identifiers 1

IdentifierTypeStateIssuer
0019235370002MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050425000535 PA Part B Supplier - Clinic/Group Practice 7911945464 Receives reassigned benefits from 1 practitioner
Practice locations: Pittsburgh, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286841600000",
    "number": "1063524726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4122 BUTLER ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152013162",
            "telephone_number": "412-682-2339",
            "fax_number": "412-682-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4122 BUTLER ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152013162",
            "telephone_number": "412-682-2339",
            "fax_number": "412-682-2809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCEVILLE VISION CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-10-12",
        "status": "A",
        "authorized_official_last_name": "STARESINIC",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "412-682-2339",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019235370002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2010; 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.