Organization Active NPI

Newtown Laser and Eye Institute

  • Ophthalmology Physician
  • Langhorne, PA
National Provider Identifier
1215980222
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
NEWTOWN LASER AND EYE INSTITUTE
Practice address
409 Executive Dr
Langhorne, PA 19047-8003
Phone
(215) 860-3400
Fax
(215) 860-8779
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Authorized official

Name
Guy Scott Mullin, M.D.NPI 1285680157
Title
President
Phone
(215) 860-3400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

409 Executive Dr
Langhorne, PA 19047-8003

Mailing address

409 Executive Dr
Langhorne, PA 19047-8003
Phone (215) 860-3400

Other identifiers 5

IdentifierTypeStateIssuer
575910OtherPABC/BS
DA1790OtherNJRAILROAD MEDICARE
2129761OtherPAAETNA
5224761OtherNJAETNA
0366355000OtherPAKEYSTONE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040824000360 PA Part B Supplier - Clinic/Group Practice 0042284267 Receives reassigned benefits from 2 practitioners
Practice locations: Langhorne, PA

National Provider Directory

National Provider Directory

Locations

414 Executive Dr
Langhorne, PA 19047
Phone (215) 860-3400

409 Executive Dr
Langhorne, PA 19047
Phone (215) 860-3400

Practitioners & affiliated clinicians

Practitioners 2

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": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480550400000",
    "number": "1215980222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 EXECUTIVE DR",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190478003",
            "telephone_number": "215-860-3400",
            "fax_number": "215-860-8779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 EXECUTIVE DR",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190478003",
            "telephone_number": "215-860-3400",
            "fax_number": "215-860-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWTOWN LASER AND EYE INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2016-12-01",
        "status": "A",
        "authorized_official_last_name": "MULLIN",
        "authorized_official_first_name": "GUY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-860-3400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "575910",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA1790",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2129761",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5224761",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "0366355000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Langhorne, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.