Clayton Manning Anderson Jr., OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG000579 Issued in PA

Practice address

784 W Main St
Mt Pleasant, PA 15666

Phone

(724) 547-6130

Fax

(724) 587-4750

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in PA2 enrollments

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 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Clayton M. Anderson, Jr. O.D.

  • Optometrist
  • N Charleroi, PA
  • NPI 1932378239

  O20100930043956

  Same enrollment

Specialty

Optometry

Education

Ohio State University - College of Optometry, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Danielle Rose Cozza, O.D.

  • Optometrist
  • North Charleroi, PA
  • NPI 1922459981
  Medicare reassignment
• Tyler McFadden, OD

  • Optometrist
  • Mt Pleasant, PA
  • NPI 1548906233
  Medicare reassignment

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.

• Clayton M. Anderson, Jr. O.D.

  • Optometrist
  • Mt Pleasant, PA
  • NPI 1427227727
  NPD Authorized official

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386720000000",
    "number": "1093827149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 REVERE ROAD",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "15425",
            "telephone_number": "724-628-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 W MAIN ST",
            "city": "MT PLEASANT",
            "state": "PA",
            "postal_code": "15666",
            "telephone_number": "724-547-6130",
            "fax_number": "724-587-4750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CLAYTON",
        "middle_name": "MANNING",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2013-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "410020130",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNOW NY INC",
            "identifier": "0587150001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "77432",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLE EYEMED",
            "identifier": "PA0579",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS",
            "identifier": "50552",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "0013245",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL VISION ADMINISTR",
            "identifier": "391976",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA BLUE SHIELD",
            "identifier": "AN146070",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarfraz Ahmad, MD
• Manuela Ilona Al Rasheed, D.M.D.
• All County Cardiology, P.C.
• Almaan El-Attrache
• John M Amoroso, DMD
• Angel Balcita, MD, PC
• David Louis Angelo, M.P.T.
• Aster Assefa, M.D.
• Aster Assefa, MD, PC
• Gregory Bailey, RPH

• Optometrist in Mt Pleasant, PA
• Providers in Mt Pleasant, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.