NPIMap

Organization Active NPI

Laurel Eye Clinic

  • Ophthalmology Physician
  • Brookville, PA
National Provider Identifier
1235120072
Registry record updated Jun 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
LAUREL EYE CLINIC
Practice address
50 Waterford Pike
Brookville, PA 15825-2518
Phone
(814) 849-8344
Fax
(814) 849-7130
NPI assigned
Nov 1, 2005
Last updated
Jun 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2009

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

Authorized official

Name
Louis D Nichamin, M.D.NPI 1265423958
Title
Managing Partner
Phone
(814) 849-8344

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X Primary

Addresses

Primary practice location

50 Waterford Pike
Brookville, PA 15825-2518

Mailing address

50 Waterford Pike
Brookville, PA 15825-2518
Phone (814) 849-8344

Other identifiers 1

IdentifierTypeStateIssuer
1007384840027MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040415000936 PA Part B Supplier - Clinic/Group Practice 9537061692 Receives reassigned benefits from 14 practitioners
1 other NPI on this enrollment
Practice locations: Seneca, PA; New Bethlehem, PA; Mercer, PA; Grove City, PA; Du Bois, PA; Duncansville, PA; Brookville, PA; Clearfield, PA

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Janice D Dunkle OD9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

50 Waterford Pike
Brookville, PA 15825
Phone (814) 849-6591

363 Broad St
Ste 4
New Bethlehem, PA 16242
Phone (814) 275-2030

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1130803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243900800000",
    "number": "1235120072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 WATERFORD PIKE",
            "city": "BROOKVILLE",
            "state": "PA",
            "postal_code": "158252518",
            "telephone_number": "814-849-8344",
            "fax_number": "814-849-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 WATERFORD PIKE",
            "city": "BROOKVILLE",
            "state": "PA",
            "postal_code": "158252518",
            "telephone_number": "814-849-8344",
            "fax_number": "814-849-7130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL EYE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-01",
        "last_updated": "2009-06-02",
        "status": "A",
        "authorized_official_last_name": "NICHAMIN",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "814-849-8344",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007384840027",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; 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.