Individual provider Active NPI

Michael S. McCaffrey, O.D.

  • Optometrist
  • South Park, PA
National Provider Identifier
1073548822
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG00503 Issued in PA
Practice address
6305 Library Rd
South Park, PA 15129-8502
Phone
(412) 854-4130
Fax
(412) 854-8175
NPI assigned
Jul 11, 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 OEG00503 PA Primary

Addresses

Primary practice location

6305 Library Rd
South Park, PA 15129-8502

Mailing address

3300 Thornwood Dr
Bethel Park, PA 15102-1542
Phone (412) 854-0508

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
I20080205000390 PA Practitioner - Optometry 9830271428 Practice locations: West Mifflin, PA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG00503PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Vision Associates Optometrist PastSince Aug 22, 2024 Accepting new patients

Organizations & group practices 1

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073548822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 THORNWOOD DR",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "151021542",
            "telephone_number": "412-854-0508",
            "fax_number": "412-854-8175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6305 LIBRARY RD",
            "city": "SOUTH PARK",
            "state": "PA",
            "postal_code": "151298502",
            "telephone_number": "412-854-4130",
            "fax_number": "412-854-8175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAFFREY",
        "first_name": "MICHAEL",
        "middle_name": "S.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG00503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Park, PA

Sources for this page

Verify at the official NPI Registry.