Individual provider Active NPI

Roger W Alburn, OD

  • Optometrist
  • West Chester, PA
National Provider Identifier
1285634626
Registry record updated Apr 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000296 Issued in PA
Practice address
915 Old Fern Hill Rd
Building B Suite 200
West Chester, PA 19380-4269
Phone
(610) 696-1230
Fax
(610) 918-0803
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000296 PA Primary

Addresses

Primary practice location

915 Old Fern Hill Rd
Building B Suite 200
West Chester, PA 19380-4269

Mailing address

915 Old Fern Hill Rd
Building B Suite 200
West Chester, PA 19380-4269
Phone (610) 696-1230

Other identifiers 2

IdentifierTypeStateIssuer
001761662MedicaidPA
0017616620002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG000296PAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271980800000",
    "number": "1285634626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 OLD FERN HILL RD",
            "address_2": "BUILDING B SUITE 200",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193804269",
            "telephone_number": "610-696-1230",
            "fax_number": "610-918-0803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 OLD FERN HILL RD",
            "address_2": "BUILDING B SUITE 200",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193804269",
            "telephone_number": "610-696-1230",
            "fax_number": "610-918-0803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALBURN",
        "first_name": "ROGER",
        "middle_name": "W",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2010-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001761662",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017616620002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, PA

Sources for this page

Verify at the official NPI Registry.