Individual provider Active NPI

Jeanette Trosino, OD

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1104319334
Registry record updated Jun 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003441 Issued in PA
Practice address
180 W Girard Ave Ste 5
Philadelphia, PA 19123-1660
Phone
(215) 554-6222
NPI assigned
Jun 12, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X OEG003441 PA Primary

Addresses

Primary practice location

180 W Girard Ave Ste 5
Philadelphia, PA 19123-1660

Mailing address

180 W Girard Ave Ste 5
Philadelphia, PA 19123-1660

Other practice location 1

1601 Kirkwood Hwy
Wilmington, DE 19805-4917
Phone (302) 994-2511

Other practice location 2

1601 Kirkwood Hwy
Wilmington, DE 19805-4917
Phone (302) 994-2511

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
I20201116000155 PA Practitioner - Optometry 2365852753 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trend Eye Care II LLCGroup PAC ID 7416264247, 2 clinicians
City Line Eye Care LLCGroup PAC ID 2961893912, 4 clinicians

Practice addresses (Care Compare)

1501 N Broad St
Suite 7
Philadelphia, PA 19122-3319
Phone (215) 866-1742

49 E City Ave
Suite 10
Bala Cynwyd, PA 19004-2421
Phone (610) 206-3866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG003441PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Trend Eye Care LLC Optometrist CurrentSince Oct 1, 2020 Accepting new patients
Roxborough Eye Care LLC Optometrist CurrentSince Oct 1, 2025 Accepting new patients
New World Vision Center, Inc. Optometrist CurrentSince Oct 1, 2020 Accepting new patients
Harbison Eye Care LLC Optometrist CurrentSince Oct 1, 2020 Accepting new patients
City Line Eye Care LLC Optometrist CurrentSince Feb 1, 2022 Accepting new patients

Locations

49 E City Ave
#10
Bala Cynwyd, PA 19004
Phone (610) 206-3866

49 E City Ave
Ste 10
Bala Cynwyd, PA 19004
Phone (610) 206-3866

612 Washington Ave
Ste 3
Philadelphia, PA 19147
Phone (215) 599-2020

180 W Girard Ave
Ste 5
Philadelphia, PA 19123
Phone (215) 554-6222

1501 N Broad St
Ste 7
Philadelphia, PA 19122
Phone (215) 360-6944

7130 Ridge Ave
Ste 7
Philadelphia, PA 19128
Phone (267) 866-7311

5597 Tulip St
Ste B8
Philadelphia, PA 19124
Phone (267) 360-6944

Organizations & group practices 6

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": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624060800000",
    "number": "1104319334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 W GIRARD AVE STE 5",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191231660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 W GIRARD AVE STE 5",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191231660",
            "telephone_number": "215-554-6222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Kirkwood Hwy",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198054917",
            "country_code": "US",
            "telephone_number": "302-994-2511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1601 Kirkwood Hwy",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198054917",
            "country_code": "US",
            "telephone_number": "302-994-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TROSINO",
        "first_name": "JEANETTE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2021-06-19",
        "certification_date": "2021-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.