Individual provider Active NPI

Marlena Mitchell-McCann

  • Optometrist
  • MC Murray, PA
National Provider Identifier
1083740872
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001172 Issued in PA
Practice address
101 Windermere CT
MC Murray, PA 15317-3671
Phone
(724) 413-7572
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG001172 PA Primary

Addresses

Primary practice location

101 Windermere CT
MC Murray, PA 15317-3671

Mailing address

101 Windermere CT
MC Murray, PA 15317-3671
Phone (724) 413-7572

Other practice location 1

2200 Washington Pike
Carnegie, PA 15106-3750
Phone (724) 413-7572

Other identifiers 1

IdentifierTypeStateIssuer
0017603240003MedicaidPA

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
I20100726000822 PA Practitioner - Optometry 7810020922 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG001172PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Marlena Mitchell-McCann Optometrist CurrentSince Feb 12, 2023 Accepting new patients
Pittsbugh Eye Care Associates Optometrist CurrentSince Mar 30, 2010 Accepting new patients

Locations

457 Washington Ave
Ste A
Bridgeville, PA 15017
Phone (412) 221-0112

2200 Washington Pike
Carnegie, PA 15106
Phone (412) 429-1649

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1083740872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 WINDERMERE CT",
            "city": "MC MURRAY",
            "state": "PA",
            "postal_code": "153173671",
            "telephone_number": "724-413-7572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WINDERMERE CT",
            "city": "MC MURRAY",
            "state": "PA",
            "postal_code": "153173671",
            "telephone_number": "724-413-7572"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Washington Pike",
            "address_purpose": "LOCATION",
            "city": "Carnegie",
            "state": "PA",
            "postal_code": "151063750",
            "country_code": "US",
            "telephone_number": "724-413-7572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL-MCCANN",
        "first_name": "MARLENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017603240003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Murray, PA

Sources for this page

Verify at the official NPI Registry.