Individual provider Active NPI

Jeremiah John Troyer, O.D.

  • Optometrist
  • Lewisburg, WV
National Provider Identifier
1154633113
Registry record updated Aug 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1081-OD Issued in WV
Practice address
213 Gateway Blvd
Suite 4
Lewisburg, WV 24901-1174
Phone
(304) 645-7797
NPI assigned
Jul 7, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1081-OD WV Primary
Optometrist 152W00000X 0618001952 VA
Optometrist 152W00000X L1832595 MI

Addresses

Primary practice location

213 Gateway Blvd
Suite 4
Lewisburg, WV 24901-1174

Mailing address

213 Gateway Blvd
Suite 4
Lewisburg, WV 24901-1174
Phone (304) 645-7797

Other identifiers 2

IdentifierTypeStateIssuer
4303101OtherWVMEDICARE PTAN
3810018087MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20101020000308 WV Practitioner - Optometry 7416140678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

170 Grand Ave
Lewisburg, WV 24901-1315
Phone (304) 645-7797

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L1832595MIMDOptometrist
0618001952VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Troyer Eye Care Inc Optometrist CurrentSince Sep 12, 2012 Accepting new patients
Dr K F Harrington & Associates Optomertists Professional Corporation Optometrist Past Accepting new patients

Locations

170 Grand Ave
Lewisburg, WV 24901
Phone (304) 645-7797

213 Gateway Blvd
Ste 4
Lewisburg, WV 24901
Phone (304) 645-7797

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": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1154633113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 GATEWAY BLVD",
            "address_2": "SUITE 4",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249011174",
            "telephone_number": "304-645-7797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 GATEWAY BLVD",
            "address_2": "SUITE 4",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249011174",
            "telephone_number": "304-645-7797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROYER",
        "first_name": "JEREMIAH",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-07",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "1081-OD",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001952",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "L1832595",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "4303101",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810018087",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, WV

Sources for this page

Verify at the official NPI Registry.