Individual provider Active NPI

Lara Ann Match, O.D.

  • Optometrist
  • Halifax, PA
National Provider Identifier
1245683267
Registry record updated Jul 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003209 Issued in PA
Practice address
901 N River Rd
Halifax, PA 17032-8940
Phone
(717) 896-3216
NPI assigned
Jul 14, 2016
Last updated
Jul 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003209 PA Primary

Addresses

Primary practice location

901 N River Rd
Halifax, PA 17032-8940

Mailing address

901 N River Rd
Halifax, PA 17032-8940
Phone (717) 896-3216

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
I20161003000023 PA Practitioner - Optometry 6002103231 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sans Pareil EyecareGroup PAC ID 7012172869, 17 clinicians

Practice addresses (Care Compare)

100 N Walnut St
Mechanicsburg Eye Associates
Mechanicsburg, PA 17055-3364
Phone (717) 766-4757

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sans Pareil Eyecare Optometrist CurrentSince Nov 16, 2018 Accepting new patients
James P. Tuttle, OD Optometrist Past Accepting new patients
Mechanicsburg Eye Associates LLC Optometrist PastSince Nov 16, 2018 Accepting new patients

Locations

25 State Ave
Carlisle, PA 17013
Phone (717) 220-8980

234 Rosedale Dr
Manchester, PA 17345
Phone (717) 266-5661

100 N Walnut St
Mechanicsburg, PA 17055
Phone (717) 628-3693

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": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1245683267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N RIVER RD",
            "city": "HALIFAX",
            "state": "PA",
            "postal_code": "170328940",
            "telephone_number": "717-896-3216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N RIVER RD",
            "city": "HALIFAX",
            "state": "PA",
            "postal_code": "170328940",
            "telephone_number": "717-896-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATCH",
        "first_name": "LARA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Halifax, PA

Sources for this page

Verify at the official NPI Registry.