Individual provider Active NPI

Andrew L Leitzel, O.D.

  • Optometrist
  • Manchester, PA
National Provider Identifier
1124020441
Registry record updated May 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001473 Issued in PA
Practice address
234 Rosedale Dr
Manchester, PA 17345-1023
Phone
(717) 266-5661
Fax
(717) 266-6510
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
No

Organizations & group practices 5

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.

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sans Pareil Eyecare 17 clinicians

Practice addresses (Care Compare)

234 Rosedale Dr
Manchester, PA 17345-1023
Phone (717) 266-5661

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
I20040914000063 PA Practitioner - Optometry 4486621075 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sans Pareil Eyecare Optometrist CurrentSince Jul 1, 2012 Accepting new patients
David L Hartzell MD Past Accepting new patients
Mechanicsburg Eye Associates LLC Optometrist PastSince Jul 1, 2012 Accepting new patients
Hartzell Eye Specialists, LLC Optometrist PastSince Feb 1, 2012 Accepting new patients
James P. Tuttle, OD Optometrist PastSince Jul 1, 2012 Accepting new patients

Locations

234 Rosedale Dr
Manchester, PA 17345
Phone (717) 266-5661

100 N Walnut St
Mechanicsburg, PA 17055
Phone (717) 766-4757

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG001473 PA Primary

Addresses

NPPES NPI Registry

Primary practice location

234 Rosedale Dr
Manchester, PA 17345-1023

Mailing address

234 Rosedale Dr
Manchester, PA 17345-1023
Phone (717) 266-5661

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
101057379MedicaidPA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 27, 2012.

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338076800000",
    "number": "1124020441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 ROSEDALE DR",
            "city": "MANCHESTER",
            "state": "PA",
            "postal_code": "173451023",
            "telephone_number": "717-266-5661",
            "fax_number": "717-266-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 ROSEDALE DR",
            "city": "MANCHESTER",
            "state": "PA",
            "postal_code": "173451023",
            "telephone_number": "717-266-5661",
            "fax_number": "717-266-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEITZEL",
        "first_name": "ANDREW",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2012-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101057379",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, PA

Sources for this page

Verify at the official NPI Registry.