Individual provider Active NPI

Jessica Ammous, OD

  • Optometrist
  • Fogelsville, PA
National Provider Identifier
1194511600
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG004264 Issued in PA
Practice address
1431 Nursery St Unit 200
Fogelsville, PA 18051-1612
Phone
(484) 273-4390
NPI assigned
Apr 21, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG004264 PA Primary

Addresses

Primary practice location

1431 Nursery St Unit 200
Fogelsville, PA 18051-1612

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622

Other practice location 1

3100 Emrick Blvd
Bethlehem, PA 18020-8061
Phone (484) 273-4390

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
I20250825000520 PA Practitioner - Optometry 0648770628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1200 S Cedar Crest Blvd
Allentown, PA 18103-6202

1200 S Cedar Crest Blvd 3Rd FL Kasych
LVPG Burn Surgery
Allentown, PA 18103-6202
Phone (610) 402-8355

1200 S Cedar Crest Blvd FL
1 LVPG Nephrology
Allentown, PA 18103-6202
Phone (610) 402-8510

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

1431 Nursery St
Fogelsville, PA 18051-1612

2100 Mack Blvd
FL 4
Allentown, PA 18103-5622

3100 Emrick Blvd
Bethlehem, PA 18020-8061
Phone (610) 402-5846

5649 Wynnewood Dr
Laurys Station, PA 18059-1124

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG004264PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Aug 4, 2025 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Aug 4, 2025 Accepting new patients
Lehigh Valley Physician Group PastSince Jan 22, 2023 Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

2100 Mack Blvd
Fl 4
Allentown, PA 18103

3100 Emrick Blvd
Bethlehem, PA 18020
Phone (484) 273-4390

1431 Nursery St
Ste 200
Fogelsville, PA 18051
Phone (484) 273-4390

1431 Nursery St
Unit 200
Fogelsville, PA 18051
Phone (484) 273-4390

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

Interoperability endpoints

  • Direct secure messaging: jammous1157056@direct2.lvhn.org

Organizations & group practices 6

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1745193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1194511600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 NURSERY ST UNIT 200",
            "city": "FOGELSVILLE",
            "state": "PA",
            "postal_code": "180511612",
            "telephone_number": "484-273-4390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 Emrick Blvd",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180208061",
            "country_code": "US",
            "telephone_number": "484-273-4390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMMOUS",
        "first_name": "JESSICA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-21",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG004264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fogelsville, PA

Sources for this page

Verify at the official NPI Registry.