Individual provider Active NPI

Peter K Mocklis, OD

  • Optometrist
  • Dover, NH
National Provider Identifier
1073655437
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
637 Issued in NH
Practice address
827 Central Ave Ste 3
Dover, NH 03820-2577
Phone
(603) 343-1123
Fax
(603) 343-1405
NPI assigned
Feb 13, 2007
Last updated
Nov 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3938 MA
Optometrist 152W00000X 637 NH Primary

Addresses

Primary practice location

827 Central Ave Ste 3
Dover, NH 03820-2577

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other practice location 1

605 Lafayette Rd
Portsmouth, NH 03801-5406
Phone (603) 427-6600

Other names 1

  • Dr. Pantelis K Mouchlis Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20080428000176 NH Practitioner - Optometry 5193803450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

865 Lafayette Rd
Hampton, NH 03842-1257
Phone (603) 926-2722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3938MAMDPsychologist
637NHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of New Hampshire, PLLC Optometrist CurrentSince Dec 30, 2021 Accepting new patients
Myeyedr Optometry of New Hampshire, PLLC Optometrist CurrentSince Dec 30, 2021 Accepting new patients
Myeyedr Optometry of New Hampshire, PLLC Optometrist CurrentSince Dec 30, 2021 Accepting new patients
Myeyedr Optometry of New Hampshire, PLLC Optometrist PastSince Nov 9, 2021 Accepting new patients
Spindel Eye Associates PC PastSince Jun 19, 2001 Accepting new patients

Locations

827 Central Ave
Ste 3
Dover, NH 03820
Phone (603) 343-1123

1 Brickyard Sq
Ste 11
Epping, NH 03042
Phone (603) 347-8377

381 S Willow St
Manchester, NH 03103
Phone (603) 382-1414

605 Lafayette Rd
Ste 1
Portsmouth, NH 03801
Phone (603) 427-6600

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1073655437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 CENTRAL AVE STE 3",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202577",
            "telephone_number": "603-343-1123",
            "fax_number": "603-343-1405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "605 Lafayette Rd",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "NH",
            "postal_code": "038015406",
            "country_code": "US",
            "telephone_number": "603-427-6600",
            "fax_number": "603-427-6670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOCKLIS",
        "first_name": "PETER",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3938",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PANTELIS",
            "last_name": "MOUCHLIS",
            "middle_name": "K",
            "prefix": "DR.",
            "credential": "OD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.