Active NPI
John W Hubbard, OD
- Optometrist
- Honesdale, PA
National Provider Identifier
1295748341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OEG001118
- Practice address
- 626 Park St
Honesdale, PA 18431 - Phone
- (570) 253-1720
- Fax
- (570) 253-0841
- NPI assigned
- Aug 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OEG001118 | PA | Primary |
Addresses
Primary practice location
626 Park St
Honesdale, PA 18431
Mailing address
200 Mifflin Ave
Scranton, PA 18503
Phone (570) 342-3145
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000548502 | Medicaid | PA | |
| HU289290 | Other | HIGH MARK BLUE SHIELD | |
| 15486 | Other | GELSINGER HEALTH PLAN | |
| 506554 | Other | AETNA | |
| 410024728 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262908800000",
"number": "1295748341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 MIFFLIN AVE",
"city": "SCRANTON",
"state": "PA",
"postal_code": "18503",
"telephone_number": "570-342-3145",
"fax_number": "570-344-1309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "626 PARK ST",
"city": "HONESDALE",
"state": "PA",
"postal_code": "18431",
"telephone_number": "570-253-1720",
"fax_number": "570-253-0841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUBBARD",
"first_name": "JOHN",
"middle_name": "W",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2010-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OEG001118",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000548502",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGH MARK BLUE SHIELD",
"identifier": "HU289290",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GELSINGER HEALTH PLAN",
"identifier": "15486",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "506554",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "410024728",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Honesdale, PA
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- Human Resources Center, Inc.
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- Barrie Robin Jacobsen, LCSW
- Crystal M James-Cobourn, D.C.
- Debra Lee Jenkins, PMHNP-BC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.