Individual provider Active NPI

Bradley J Carneal

  • Optician
  • Indiana, PA
National Provider Identifier
1114603891
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Practice address
3100 Oakland Ave Ste 1C
Indiana, PA 15701-3277
Phone
(724) 349-5671
Fax
(724) 349-6375
NPI assigned
Jun 26, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X Primary

Addresses

Primary practice location

3100 Oakland Ave Ste 1C
Indiana, PA 15701-3277

Mailing address

187 Rinkus Dr
Indiana, PA 15701-8461
Phone (314) 596-6721

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1114603891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 RINKUS DR",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157018461",
            "telephone_number": "314-596-6721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 OAKLAND AVE STE 1C",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013277",
            "telephone_number": "724-349-5671",
            "fax_number": "724-349-6375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNEAL",
        "first_name": "BRADLEY",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-26",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indiana, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.