Presque Isle Optique LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEGOO1057 Issued in PA

Legal business name

PRESQUE ISLE OPTIQUE LLC

Practice address

147 W 18TH St
Erie, PA 16501-2103

Phone

(814) 454-7138

NPI assigned

Nov 14, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Gerald M. Stefanic

Title

Optician/Owner

Phone

(814) 454-7138

Specialties & licenses 2

Addresses

Other names 1

• Council Optometric Center Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 1

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

• William T Lenart, OD

  • Optometrist
  • Erie, PA
  • NPI 1427038785
  Medicare reassignment NPD

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321228800000",
    "number": "1104103456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 W 18TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165012103",
            "telephone_number": "814-454-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 W 18TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165012103",
            "telephone_number": "814-454-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESQUE ISLE OPTIQUE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-14",
        "last_updated": "2011-11-14",
        "status": "A",
        "authorized_official_last_name": "STEFANIC",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OPTICIAN/OWNER",
        "authorized_official_telephone_number": "814-454-7138",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEGOO1057",
            "primary": true
        },
        {
            "code": "156F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Council Optometric Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Presbyterian Homes in the Presbytery of Lake Erie
• Pamela Ann Presler, M.S.W., L.C.S.W.
• Presque Isle Colon and Rectal Surgery
• Presque Isle Family Medicine
• Presque Isle Mind-Body Wellness Center, PLLC
• Presque Isle Orthopedic Laboratory Inc.
• Presque Isle Psychiatric Associates
• Nicholas J Price
• Cynthia Ann Priester, MS, OTR-L
• Primary Health Network

• Optometrist in Erie, PA
• Providers in Erie, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.