Individual provider Active NPI

Thomas Heeter, O.D.

  • Optometrist
  • Seneca, PA
National Provider Identifier
1104896687
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OP489143 Issued in PA
Practice address
3108 State Route 257
Seneca, PA 16346-2426
Phone
(814) 677-7048
NPI assigned
Jan 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OP489143 PA Primary

Addresses

Primary practice location

3108 State Route 257
Seneca, PA 16346-2426

Mailing address

3108 State Route 257
Seneca, PA 16346-2426
Phone (814) 677-7048

Other identifiers 1

IdentifierTypeStateIssuer
0017373530002OtherPAPA STATE MEDICAL ASSISTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OP489143PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optical World 257 Inc. PastSince Dec 18, 2011 Accepting new patients

Organizations & group practices 1

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1104896687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3108 STATE ROUTE 257",
            "city": "SENECA",
            "state": "PA",
            "postal_code": "163462426",
            "telephone_number": "814-677-7048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3108 STATE ROUTE 257",
            "city": "SENECA",
            "state": "PA",
            "postal_code": "163462426",
            "telephone_number": "814-677-7048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEETER",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OP489143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA STATE MEDICAL ASSISTAN",
            "identifier": "0017373530002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.