Organization Active NPI

George W. Kledaras, O.D., P.a.

  • Optometrist
  • Wilmington, DE
National Provider Identifier
1154461432
Registry record updated Apr 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
I30001166 Issued in DE
Legal business name
GEORGE W. KLEDARAS, O.D., P.A.
Practice address
230 Philadelphia Pike
Wilmington, DE 19809-3125
Phone
(302) 764-4613
Fax
(302) 764-3201
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2010

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

Authorized official

Name
Dr. George W Kledaras, O.D.
Title
President
Phone
(302) 764-4613

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X I30001166 DE Primary

Addresses

Primary practice location

230 Philadelphia Pike
Wilmington, DE 19809-3125

Mailing address

230 Philadelphia Pike
Wilmington, DE 19809-3125
Phone (302) 764-4613

Other identifiers 1

IdentifierTypeStateIssuer
0000172422MedicaidDE

National Provider Directory

National Provider Directory

Locations

230 Philadelphia Pike
Wilmington, DE 19809
Phone (302) 764-4613

Practitioners & affiliated clinicians

Practitioners 1

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": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271635200000",
    "number": "1154461432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 PHILADELPHIA PIKE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198093125",
            "telephone_number": "302-764-4613",
            "fax_number": "302-764-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 PHILADELPHIA PIKE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198093125",
            "telephone_number": "302-764-4613",
            "fax_number": "302-764-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE W. KLEDARAS, O.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2010-04-19",
        "status": "A",
        "authorized_official_last_name": "KLEDARAS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "302-764-4613",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "DE",
            "license": "I30001166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000172422",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2010; 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.