Individual provider Active NPI

Gary L Reck, OD

  • Optometrist
  • Delmont, PA
National Provider Identifier
1073515482
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OE6001104 Issued in PA
Practice address
506 Athena Dr
Delmont, PA 15626-1005
Phone
(724) 468-6869
Fax
(724) 468-6207
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OE6001104 PA Primary

Addresses

Primary practice location

506 Athena Dr
Delmont, PA 15626-1005

Mailing address

506 Athena Dr
Delmont, PA 15626-1005
Phone (724) 468-6869

Other identifiers 2

IdentifierTypeStateIssuer
0015200410002MedicaidPA
356208500MedicaidMD

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
I20040209000671 PA Practitioner - Optometry 9931093309 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Insight Eye Consultants to Nursing FacilitiesGroup PAC ID 4385826908, 4 clinicians

Practice addresses (Care Compare)

1040 Old Orchard Dr
Gibsonia, PA 15044-6080
Phone (412) 597-3737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OE6001104PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Eye Consultants to Nursing Facilities Inc Optometrist CurrentSince Jan 1, 2011 Accepting new patients
Sto-Rox Neighborhood Health Council, Inc. Current Accepting new patients
Sto-Rox Neighborhood Health Council, Inc. CurrentSince Sep 5, 2017 Accepting new patients
Insight Services for the Visually Impaired Optometrist PastSince Jan 1, 1990 Accepting new patients

Locations

506 Athena Dr
Delmont, PA 15626

710 Thompson Ave
Mc Kees Rocks, PA 15136
Phone (412) 771-6462

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482192000000",
    "number": "1073515482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 ATHENA DR",
            "city": "DELMONT",
            "state": "PA",
            "postal_code": "156261005",
            "telephone_number": "724-468-6869",
            "fax_number": "724-468-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 ATHENA DR",
            "city": "DELMONT",
            "state": "PA",
            "postal_code": "156261005",
            "telephone_number": "724-468-6869",
            "fax_number": "724-468-6207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RECK",
        "first_name": "GARY",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2016-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OE6001104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015200410002",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "356208500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delmont, PA

Sources for this page

Verify at the official NPI Registry.