Active NPI
Barry L Gellis, O.D.
- Optometrist
- Erie, PA
National Provider Identifier
1235122136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OEG001073
- Practice address
- 311 W 24TH St
Ste 401
Erie, PA 16502-2665 - Phone
- (814) 455-7591
- Fax
- (814) 454-1467
- NPI assigned
- Aug 25, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OEG001073 | PA | Primary |
Addresses
Primary practice location
311 W 24TH St
Ste 401
Erie, PA 16502-2665
Mailing address
311 W 24TH St
Ste 401
Erie, PA 16502-2665
Phone (814) 455-7591
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0005620100004 | Medicaid | PA | |
| 0739350001 | Other | DMERC | |
| GE60796 | Other | BS | |
| P00178464 | Other | GBA RR | |
| OEG001073 | Other | PA | PA NUMBER |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1235122136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 W 24TH ST",
"address_2": "STE 401",
"city": "ERIE",
"state": "PA",
"postal_code": "165022665",
"telephone_number": "814-455-7591",
"fax_number": "814-454-1467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 W 24TH ST",
"address_2": "STE 401",
"city": "ERIE",
"state": "PA",
"postal_code": "165022665",
"telephone_number": "814-455-7591",
"fax_number": "814-454-1467"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GELLIS",
"first_name": "BARRY",
"middle_name": "L",
"name_prefix": "Mr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-25",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OEG001073",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0005620100004",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMERC",
"identifier": "0739350001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BS",
"identifier": "GE60796",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GBA RR",
"identifier": "P00178464",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA NUMBER",
"identifier": "OEG001073",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.