Individual provider Active NPI

Ira Charles Zeitlin, O.D.

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1104802404
Registry record updated May 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OE005729T Issued in PA
Practice address
3935 Chestnut St
Philadelphia, PA 19104-3110
Phone
(215) 386-6200
NPI assigned
Dec 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OE005729T PA Primary

Addresses

Primary practice location

3935 Chestnut St
Philadelphia, PA 19104-3110

Mailing address

3935 Chestnut St
Philadelphia, PA 19104-3181
Phone (215) 386-6200

Other identifiers 1

IdentifierTypeStateIssuer
0145640501MedicaidPA

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
I20080716000080 PA Practitioner - Optometry 9537232160 Practice locations: Glenside, PA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

115 E Glenside Ave
Suite 2
Glenside, PA 19038-4618
Phone (215) 578-7161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OE005729TPAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Spring House Eye Associates, LLC Optometrist Past Accepting new patients
Leon I Schwartz OD & Ira C Zeitlin OD PTR Optometrist PastSince Jan 1, 2008 Accepting new patients
Homesight PLLC Optometrist PastSince Feb 26, 2018 Accepting new patients

Organizations & group practices 3

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209945600000",
    "number": "1104802404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3935 CHESTNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043181",
            "telephone_number": "215-386-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3935 CHESTNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043110",
            "telephone_number": "215-386-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEITLIN",
        "first_name": "IRA",
        "middle_name": "CHARLES",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2008-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OE005729T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0145640501",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.