Individual provider Active NPI

Irene Elizabeth Ravkin, OD

  • Optometrist
  • Lewisburg, PA
National Provider Identifier
1295419752
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG004007 Issued in PA
Practice address
2212 Old Turnpike Rd
Lewisburg, PA 17837-6521
Phone
(570) 523-9234
NPI assigned
Jun 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG004007 PA Primary

Addresses

Primary practice location

2212 Old Turnpike Rd
Lewisburg, PA 17837-6521

Mailing address

17211 Cub Cir
Bloomsburg, PA 17815-8007
Phone (216) 386-2176

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
I20230911000490 PA Practitioner - Optometry 9436518578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Lipski Eye Center PCGroup PAC ID 9234103029, 4 clinicians

Practice addresses (Care Compare)

2212 Old Turnpike Rd
Ofc
Lewisburg, PA 17837-6521
Phone (570) 523-9234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG004007PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lipski Eye Center PC Optometrist CurrentSince Aug 28, 2023 Accepting new patients

Locations

2212 Old Turnpike Rd
Ofc
Lewisburg, PA 17837
Phone (570) 523-9234

2212 Old Turnpike Rd
Lewisburg, PA 17837
Phone (570) 523-9234

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": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1295419752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17211 CUB CIR",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178158007",
            "telephone_number": "216-386-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 OLD TURNPIKE RD",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178376521",
            "telephone_number": "570-523-9234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVKIN",
        "first_name": "IRENE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG004007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, PA

Sources for this page

Verify at the official NPI Registry.