Jonathan William Fennell, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG004338 Issued in PA

Practice address

20808 Route 19
Cranberry Township, PA 16066-6022

Phone

(724) 591-8212

Fax

(724) 320-3903

NPI assigned

Jan 27, 2026

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Indiana University - School of Optometry, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Pennsylvania Professional IncGroup PAC ID 7719218593, 80 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Aeg Pennsylvania Professional Inc

  • Optometrist
  • Pittsburgh, PA
  • NPI 1851958854
  Medicare reassignment Care Compare group
• Aeg Pennsylvania Professional, Inc

  • Optometrist
  • Pittsburgh, PA
  • NPI 1932604220
  NPD (past)

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

{
    "created_epoch": "1769472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1295684686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 BRANCHTON RD",
            "city": "BOYERS",
            "state": "PA",
            "postal_code": "160201406",
            "telephone_number": "724-496-4936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20808 ROUTE 19",
            "city": "CRANBERRY TOWNSHIP",
            "state": "PA",
            "postal_code": "160666022",
            "telephone_number": "724-591-8212",
            "fax_number": "724-320-3903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNELL",
        "first_name": "JONATHAN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-27",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG004338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Evans, M.D.
• Luke Fabisiak, MS, LPC
• Family Vision Care, PLLC
• Jaime Jo Farrer, NP
• Sandra J. Federo, CRNP
• Kelly Elizabeth Ferian
• Matthew M Firek, PHARM, D.
• Forefront Dermatology, S.C.
• Karianne Frank, LMT
• Jennifer Lynn Fuchs, LMFT

• Optometrist in Cranberry Township, PA
• Providers in Cranberry Township, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.