Organization Active NPI

Mayfair Eye Associates, PC

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1225251168
Registry record updated Dec 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000179 Issued in PA
Legal business name
MAYFAIR EYE ASSOCIATES, PC
Practice address
6921 Frankford Ave
Suite E
Philadelphia, PA 19135-1623
Phone
(215) 624-0416
Fax
(215) 624-2770
NPI assigned
Apr 10, 2007
Last updated
Dec 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2008

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

Authorized official

Name
Mrs. Andrea Schmidt
Title
Office Manager
Phone
(215) 624-0416

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000179 PA Primary

Addresses

Primary practice location

6921 Frankford Ave
Suite E
Philadelphia, PA 19135-1623

Mailing address

6921 Frankford Ave
Suite E
Philadelphia, PA 19135-1623
Phone (215) 624-0416

Other identifiers 1

IdentifierTypeStateIssuer
137726OtherPTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081119000321 PA Part B Supplier - Clinic/Group Practice 3274693353 Receives reassigned benefits from 6 practitioners
Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory

Locations

6921 Frankford Ave
Ste E
Philadelphia, PA 19135
Phone (215) 624-0416

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228694400000",
    "number": "1225251168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6921 FRANKFORD AVE",
            "address_2": "SUITE E",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191351623",
            "telephone_number": "215-624-0416",
            "fax_number": "215-624-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6921 FRANKFORD AVE",
            "address_2": "SUITE E",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191351623",
            "telephone_number": "215-624-0416",
            "fax_number": "215-624-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYFAIR EYE ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2008-12-08",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "215-624-0416",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "137726",
            "state": null
        }
    ],
    "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 Dec 8, 2008; 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.