Individual provider Active NPI

Chhapean Vibol, OD

  • Optometrist
  • Bala Cynwyd, PA
National Provider Identifier
1184294183
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
000000 Issued in PA
Practice address
2 Conshohocken State Rd
Bala Cynwyd, PA 19004-3386
Phone
(610) 668-1373
NPI assigned
Jun 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 000000 PA Primary

Addresses

Primary practice location

2 Conshohocken State Rd
Bala Cynwyd, PA 19004-3386

Mailing address

2 Conshohocken State Rd
Bala Cynwyd, PA 19004-3386
Phone (610) 668-1373

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
I20220120000606 PA Practitioner - Optometry 6507258779 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000000PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionworks, Inc CurrentSince Mar 20, 2023 Accepting new patients
Alpha Eye Plymouth Meeting, LLC Optometrist CurrentSince Jan 1, 2022 Accepting new patients
Visionworks, Inc. Optometrist CurrentSince Mar 20, 2023 Accepting new patients

Locations

2 Conshohocken State Rd
Bala Cynwyd, PA 19004
Phone (610) 668-1373

560 Millcreek Mall
Erie, PA 16565
Phone (814) 868-8540

2300 E Lincoln Hwy
Langhorne, PA 19047
Phone (215) 750-3760

661 W Germantown Pike
Plymouth Meeting, PA 19462
Phone (610) 941-9780

661 W Germantown Pike
Ste 101
Plymouth Meeting, PA 19462
Phone (610) 941-4149

Organizations & group practices 3

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": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1184294183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CONSHOHOCKEN STATE RD",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190043386",
            "telephone_number": "610-668-1373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CONSHOHOCKEN STATE RD",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190043386",
            "telephone_number": "610-668-1373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIBOL",
        "first_name": "CHHAPEAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

Verify at the official NPI Registry.