Individual provider Active NPI

Barry Raymond Kanofsky, O.D.

  • Optometrist
  • Kennett Square, PA
National Provider Identifier
1083638126
Registry record updated Sep 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000186 Issued in PA
Practice address
217 E State St
Kennett Square, PA 19348-3123
Phone
(610) 444-5522
Fax
(610) 444-1568
NPI assigned
Jul 26, 2006
Last updated
Sep 29, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000186 PA Primary

Addresses

Primary practice location

217 E State St
Kennett Square, PA 19348-3123

Mailing address

217 East State Street
Kennett Square, PA 19348
Phone (610) 444-5522

Other identifiers 8

IdentifierTypeStateIssuer
000092639OtherPABLUE CROSS PERSONAL CHOIC
0017858OtherPAAETNA
12941OtherPASPECTERA
52883OtherPADAVIS VISION
232152757OtherPAVISION SERVICE PLAN
231896238OtherDEBLUE CROSS OF DE
PA04683OtherPAVISION BENEFITS OF AMERIC
PA4683OtherPAEYEMED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222646400000",
    "number": "1083638126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 EAST STATE STREET",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "19348",
            "telephone_number": "610-444-5522",
            "fax_number": "610-444-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 E STATE ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483123",
            "telephone_number": "610-444-5522",
            "fax_number": "610-444-1568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANOFSKY",
        "first_name": "BARRY",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2008-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PERSONAL CHOIC",
            "identifier": "000092639",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0017858",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "12941",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "52883",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISION SERVICE PLAN",
            "identifier": "232152757",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF DE",
            "identifier": "231896238",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISION BENEFITS OF AMERIC",
            "identifier": "PA04683",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "PA4683",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennett Square, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.