Individual provider Active NPI

Ralph E. Gilmore Jr., O.D.

  • Optometrist
  • Bethlehem, PA
National Provider Identifier
1073525911
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000053 Issued in PA
Practice address
547 Main St
Bethlehem, PA 18018-5810
Phone
(610) 866-5815
Fax
(861) 866-2450
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000053 PA Primary

Addresses

Primary practice location

547 Main St
Bethlehem, PA 18018-5810

Mailing address

547 Main St.
Bethlehem, PA 18018-5810
Phone (610) 866-5815

Other identifiers 5

IdentifierTypeStateIssuer
5843508OtherPAAETNA
GI641469OtherPAHIGHMARK BLUE SHIELD
0471935000OtherPAINDEPENDENCE BLUE CROSS
01994101OtherPACAPITAL BLUE CROSS/ CAIC
9423059OtherPAPRIVATE HEALTHCARE SYSTEM

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
I20100504000780 PA Practitioner - Optometry 9335277862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bethlehem Eye Care Associates, P. C.Group PAC ID 3870578461, 2 clinicians

Practice addresses (Care Compare)

547 Main St
Bethlehem, PA 18018-5810
Phone (610) 866-5815

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG000053PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bethlehem Eye Care Associates, P. C. Optometrist CurrentSince Jan 31, 1991 Accepting new patients
Bethlehem Eye Care Associates, P. C. PastSince Jan 31, 1991 Accepting new patients

Locations

547 Main St
Bethlehem, PA 18018
Phone (610) 866-5815

Organizations & group practices 2

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073525911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 MAIN ST.",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180185810",
            "telephone_number": "610-866-5815",
            "fax_number": "610-866-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "547 MAIN ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180185810",
            "telephone_number": "610-866-5815",
            "fax_number": "861-866-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "RALPH",
        "middle_name": "E.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5843508",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "GI641469",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "0471935000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS/ CAIC",
            "identifier": "01994101",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "9423059",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.