Individual provider Active NPI

Matthew Brodkin, OD

  • Optometrist
  • Langhorne, PA
National Provider Identifier
1083283485
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003783 Issued in PA
Practice address
2300 E Lincoln Hwy
Langhorne, PA 19047-1824
Phone
(215) 750-3760
NPI assigned
Jun 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003783 PA Primary

Addresses

Primary practice location

2300 E Lincoln Hwy
Langhorne, PA 19047-1824

Mailing address

71 Bortons Rd
Marlton, NJ 08053-5406

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
I20210804001428 PA Practitioner - Optometry 5092119602 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Visionworks, Inc CurrentSince Jul 12, 2021 Accepting new patients
Visionworks, Inc. Optometrist CurrentSince Jul 12, 2021 Accepting new patients

Locations

560 Millcreek Mall
Erie, PA 16565
Phone (814) 868-8540

2300 E Lincoln Hwy
Langhorne, PA 19047
Phone (215) 750-3760

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, 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": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1083283485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 BORTONS RD",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080535406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 E LINCOLN HWY",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190471824",
            "telephone_number": "215-750-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODKIN",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Langhorne, PA

Sources for this page

Verify at the official NPI Registry.