Organization Active NPI

Pocono Eye Associates Inc

  • Ophthalmology Physician
  • East Stroudsburg, PA
National Provider Identifier
1285690628
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
POCONO EYE ASSOCIATES INC
Practice address
300 Plaza CT
Ste a
East Stroudsburg, PA 18301-8260
Phone
(570) 421-8842
Fax
(570) 476-5842
NPI assigned
Apr 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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

Authorized official

Name
Ms. Dawn E Hoffman
Title
Administrator
Phone
(570) 421-8842

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X PA
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X PA Primary

Addresses

Primary practice location

300 Plaza CT
Ste a
East Stroudsburg, PA 18301-8260

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1007741030005MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040607000687 PA Part B Supplier - Clinic/Group Practice 9436131026 Receives reassigned benefits from 12 practitioners
Practice locations: E Stroudsburg, PA; Tobyhanna, PA; Brodheadsville, PA
O20100930050919 PA DME Supplier - Physician - OphthalmologyDME Supplier - Physician - OptometristDME Supplier - Optician 9436131026 Practice locations: East Stroudsburg, PA

National Provider Directory

National Provider Directory

Locations

120 Burrus Blvd
Ste 110
Brodheadsville, PA 18322
Phone (570) 992-4000

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

100 Community Dr
Ste 204A
Tobyhanna, PA 18466
Phone (570) 895-4550

100 Community Dr
Ste 204
Tobyhanna, PA 18466

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or 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-2",
    "last_updated_epoch": "1379548800000",
    "number": "1285690628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PLAZA COURT",
            "address_2": "STE A",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "18301",
            "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 CT",
            "address_2": "STE A",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183018260",
            "telephone_number": "570-421-8842",
            "fax_number": "570-476-5842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POCONO EYE ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-25",
        "last_updated": "2013-09-19",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "570-421-8842",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007741030005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.