Individual provider Active NPI

Travis James Gabriel, O.D.

  • Optometrist
  • Wyomissing, PA
National Provider Identifier
1073965943
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003182 Issued in PA
Practice address
1802 Papermill Rd
Wyomissing, PA 19610-1100
Phone
(610) 372-0712
Fax
(610) 376-6968
NPI assigned
Jul 5, 2016
Last updated
Aug 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003182 PA Primary
Ophthalmology Physician 207W00000X OEG003182 PA

Addresses

Primary practice location

1802 Papermill Rd
Wyomissing, PA 19610-1100

Mailing address

1802 Papermill Rd
Wyomissing, PA 19610-1100
Phone (610) 372-0712

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
I20170216000068 PA Practitioner - Optometry 9830472935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Berks Eye Physicians and Surgeons LTDGroup PAC ID 6406845494, 8 clinicians

Practice addresses (Care Compare)

1802 Papermill Rd
Wyomissing, PA 19610-1100
Phone (610) 372-0712

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Berks Eye Physicians & Surgeons LTD Optometrist CurrentSince Jul 22, 2019 Accepting new patients

Locations

1802 Papermill Rd
Wyomissing, PA 19610
Phone (610) 372-0712

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, 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": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1073965943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 PAPERMILL RD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101100",
            "telephone_number": "610-372-0712",
            "fax_number": "610-376-6968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 PAPERMILL RD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101100",
            "telephone_number": "610-372-0712",
            "fax_number": "610-376-6968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABRIEL",
        "first_name": "TRAVIS",
        "middle_name": "JAMES",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-05",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003182",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "OEG003182",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.