Individual provider Active NPI

Yasmin Vesamia, OD

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1134474299
Registry record updated Jul 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG002611 Issued in PA
Practice address
2118 Cottman Ave
Philadelphia, PA 19149-1133
Phone
(215) 725-1209
NPI assigned
Jul 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG002611 PA Primary

Addresses

Primary practice location

2118 Cottman Ave
Philadelphia, PA 19149-1133

Mailing address

8480 Limekiln Pike
Apartment 320
Wyncote, PA 19095-2801
Phone (407) 443-8056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20150316002366 GA Practitioner - Optometry 1759608508 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG002611PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Lynn O.D. & Associates, PC CurrentSince Nov 1, 2014 Accepting new patients
Mark Lynn OD & Associates, PC Optometrist CurrentSince Nov 1, 2014 Accepting new patients

Locations

1530 Market Place Blvd
Ste D
Cumming, GA 30041
Phone (678) 513-8541

2929 Turner Hill Rd
Ste 2625
Lithonia, GA 30038
Phone (770) 482-5050

Organizations & group practices 2

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": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1134474299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8480 LIMEKILN PIKE",
            "address_2": "APARTMENT 320",
            "city": "WYNCOTE",
            "state": "PA",
            "postal_code": "190952801",
            "telephone_number": "407-443-8056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191491133",
            "telephone_number": "215-725-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VESAMIA",
        "first_name": "YASMIN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.