Individual provider Active NPI

Derek J Pyle, OD

  • Optometrist
  • East Stroudsburg, PA
National Provider Identifier
1285690495
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001518 Issued in PA
Practice address
300 Plaza Court
Suite a
East Stroudsburg, PA 18301-8260
Phone
(570) 421-8842
Fax
(570) 476-5842
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG001518 PA Primary

Addresses

Primary practice location

300 Plaza Court
Suite a
East Stroudsburg, PA 18301-8260

Mailing address

300 Plaza Court
Suite a
East Stroudsburg, PA 18301-8260
Phone (570) 421-8842

Other identifiers 1

IdentifierTypeStateIssuer
1014751900001MedicaidPA

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
I20050113000104 PA Practitioner - Optometry 7315996782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pocono Eye Associates IncGroup PAC ID 9436131026, 10 clinicians

Practice addresses (Care Compare)

300 Plaza CT
Suite a
E Stroudsburg, PA 18301-8260
Phone 57042188421007

Merit-based Incentive Payment System (MIPS)

Final score
86.85 of 100Reported as group
Quality
87.82
Improvement activities
40
Cost
72.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OEG001518PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pocono Eye Associates Inc Optometrist CurrentSince Aug 16, 2004 Accepting new patients

Locations

1650 Route 209
Brodheadsville, PA 18322
Phone (570) 992-4000

300 Plaza Ct
Ste A
East Stroudsburg, PA 18301
Phone (570) 421-8842

Interoperability endpoints

  • Direct secure messaging: djp@poconoeye.direct.eyemdemr.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378944000000",
    "number": "1285690495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PLAZA COURT",
            "address_2": "SUITE A",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183018260",
            "telephone_number": "570-421-8842",
            "fax_number": "570-476-5842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PLAZA COURT",
            "address_2": "SUITE A",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183018260",
            "telephone_number": "570-421-8842",
            "fax_number": "570-476-5842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PYLE",
        "first_name": "DEREK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2013-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014751900001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Stroudsburg, PA

Sources for this page

Verify at the official NPI Registry.