NPIMap

Individual provider Active NPI

Peter Robert Laibson, MD

  • Ophthalmology Physician
  • Philadelphia, PA
National Provider Identifier
1194723841
Registry record updated Jul 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD008438E Issued in PA
Practice address
840 Walnut Street
Suite 920 Attn: Corneal Associates, PC
Philadelphia, PA 19107-5109
Phone
(215) 928-3180
Fax
(215) 928-3854
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD008438E PA Primary

Addresses

Primary practice location

840 Walnut Street
Suite 920 Attn: Corneal Associates, PC
Philadelphia, PA 19107-5109

Mailing address

840 Walnut Street
Suite 920 Attn: Corneal Associates, PC
Philadelphia, PA 19107-5109
Phone (215) 928-3180

Other identifiers 3

IdentifierTypeStateIssuer
0007630720004MedicaidPA
0005434OtherAETNA
016766OtherPABLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD008438EPAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Corneal Associates, PC Ophthalmology Past Accepting new patients
Vantage Eyecare, LLC Past Accepting new patients

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248998400000",
    "number": "1194723841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 WALNUT STREET",
            "address_2": "SUITE 920 ATTN: CORNEAL ASSOCIATES, PC",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075109",
            "telephone_number": "215-928-3180",
            "fax_number": "215-928-3854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 WALNUT STREET",
            "address_2": "SUITE 920 ATTN: CORNEAL ASSOCIATES, PC",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075109",
            "telephone_number": "215-928-3180",
            "fax_number": "215-928-3854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIBSON",
        "first_name": "PETER",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2009-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD008438E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007630720004",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005434",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "016766",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2009; 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.