Active NPI
Ira Lippman, OD
- Optometrist
- North Wales, PA
National Provider Identifier
1063598852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OE5134T
- Practice address
- 205 Montgomery Mall
North Wales, PA 19454 - Phone
- (215) 362-2241
- Fax
- (215) 362-8696
- NPI assigned
- Oct 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OE5134T | PA | Primary |
Addresses
Primary practice location
205 Montgomery Mall
North Wales, PA 19454
Mailing address
205 Montgomery Mall
North Wales, PA 19454
Phone (215) 362-2241
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1644263 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OE5134T | PA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202947200000",
"number": "1063598852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 MONTGOMERY MALL",
"city": "NORTH WALES",
"state": "PA",
"postal_code": "19454",
"telephone_number": "215-362-2241",
"fax_number": "215-362-8696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 MONTGOMERY MALL",
"city": "NORTH WALES",
"state": "PA",
"postal_code": "19454",
"telephone_number": "215-362-2241",
"fax_number": "215-362-8696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIPPMAN",
"first_name": "IRA",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-27",
"last_updated": "2008-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OE5134T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1644263",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Wales, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.