Organization Active NPI

Vistaura Eye PC

  • Ophthalmology Physician
  • Harrisburg, PA
National Provider Identifier
1114950144
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
VISTAURA EYE PC
Practice address
10 Capital Dr.
Suite 300
Harrisburg, PA 17110
Phone
(717) 233-3937
Fax
(717) 233-5715
NPI assigned
Jul 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Authorized official

Name
Gautam MishraNPI 1295723385
Title
President
Phone
(717) 233-3937

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
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

10 Capital Dr.
Suite 300
Harrisburg, PA 17110

Mailing address

10 Capital Drive
Suite 300
Harrisburg, PA 17110
Phone (717) 233-3937

Other identifiers 1

IdentifierTypeStateIssuer
CA3279OtherPARAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040607000513 PA Part B Supplier - Clinic/Group Practice 6305828971 Receives reassigned benefits from 3 practitioners
Practice locations: Harrisburg, PA

National Provider Directory

National Provider Directory

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Locations

2509 N Front St
Harrisburg, PA 17110
Phone (717) 233-3937

10 Capital Dr
Ste 300
Harrisburg, PA 17110
Phone (717) 233-3937

1831 E Chocolate Ave
Hershey, PA 17033
Phone (717) 533-5990

Practitioners & affiliated clinicians

Practitioners 3

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": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751328000000",
    "number": "1114950144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CAPITAL DRIVE",
            "address_2": "SUITE 300",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "17110",
            "telephone_number": "717-233-3937",
            "fax_number": "717-233-5715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CAPITAL DR.",
            "address_2": "SUITE 300",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "17110",
            "telephone_number": "717-233-3937",
            "fax_number": "717-233-5715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTAURA EYE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A",
        "authorized_official_last_name": "MISHRA",
        "authorized_official_first_name": "GAUTAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-233-3937"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA3279",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.