Individual provider Active NPI

David Hardic, OD

  • Optometrist
  • West Grove, PA
National Provider Identifier
1235139478
Registry record updated May 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000831 Issued in PA
Practice address
57 Jenners Village Ctr
West Grove, PA 19390-8102
Phone
(610) 869-4200
Fax
(610) 869-2511
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000831 PA Primary

Addresses

Primary practice location

57 Jenners Village Ctr
West Grove, PA 19390-8102

Mailing address

57 Jenners Village Ctr
West Grove, PA 19390-8102
Phone (610) 869-4200

Other identifiers 1

IdentifierTypeStateIssuer
001400099MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050513000047 PA Practitioner - Optometry 2860433448 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eric R. Miller, OD, PCGroup PAC ID 3476591397, 5 clinicians

Practice addresses (Care Compare)

57 Jenners Village Ctr
West Grove, PA 19390-8102
Phone (610) 869-4200

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG000831PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Eye Consultants to Nursing Facilities Inc Optometrist CurrentSince May 21, 2011 Accepting new patients
Eric R. Miller, OD, PC Optometrist CurrentSince May 22, 2009 Accepting new patients
Eric R. Miller, OD, PC PastSince May 22, 2009 Accepting new patients
Insight Services for the Visually Impaired Optometrist Past Accepting new patients

Locations

506 Athena Dr
Delmont, PA 15626

57 Jenners Village Ctr
West Grove, PA 19390
Phone (610) 869-4200

Interoperability endpoints

  • Direct secure messaging: millereyecare4@directaddress.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401148800000",
    "number": "1235139478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 JENNERS VILLAGE CTR",
            "city": "WEST GROVE",
            "state": "PA",
            "postal_code": "193908102",
            "telephone_number": "610-869-4200",
            "fax_number": "610-869-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 JENNERS VILLAGE CTR",
            "city": "WEST GROVE",
            "state": "PA",
            "postal_code": "193908102",
            "telephone_number": "610-869-4200",
            "fax_number": "610-869-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDIC",
        "first_name": "DAVID",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2014-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001400099",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Grove, PA

Sources for this page

Verify at the official NPI Registry.