Organization Active NPI

Koury Family Eye Care, LLC

  • Optometrist
  • Hanover, PA
National Provider Identifier
1104188044
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001409 Issued in PA
Legal business name
KOURY FAMILY EYE CARE, LLC
Practice address
495 Eisenhower Dr
Hanover, PA 17331-5215
Phone
(717) 969-8708
Fax
(844) 440-1823
NPI assigned
Jun 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Authorized official

Name
Dr. John J Koury, O.D.NPI 1558393298
Title
Member
Phone
(717) 969-8708

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OEG001409 PA Primary

Addresses

Primary practice location

495 Eisenhower Dr
Hanover, PA 17331-5215

Mailing address

495 Eisenhower Dr
Hanover, PA 17331-5215
Phone (717) 969-8708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120906000334 PA Part B Supplier - Clinic/Group Practice 0244487718 Receives reassigned benefits from 1 practitioner
Practice locations: Hanover, PA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2275682Koury Family Eye Care495 Eisenhower Drive, Hanover, PA 17331Certificate of waiverJan 25, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753401600000",
    "number": "1104188044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 EISENHOWER DR",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173315215",
            "telephone_number": "717-969-8708",
            "fax_number": "844-440-1823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 EISENHOWER DR",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173315215",
            "telephone_number": "717-969-8708",
            "fax_number": "844-440-1823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOURY FAMILY EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-15",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A",
        "authorized_official_last_name": "KOURY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "717-969-8708",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.