NPIMap

Organization Active NPI

Ic Laser Eye Care, P.C.

  • Ophthalmology Physician
  • Bensalem, PA
National Provider Identifier
1295826485
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD056677L Issued in PA
Legal business name
IC LASER EYE CARE, P.C.
Practice address
3046 Knights Rd
Bensalem, PA 19020
Phone
(215) 639-4500
Fax
(215) 604-0355
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

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

Authorized official

Name
Dr. Aisha Chaudhry, M.D.
Title
Physician
Phone
(215) 639-4500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X MD056677L PA Primary

Addresses

Primary practice location

3046 Knights Rd
Bensalem, PA 19020

Mailing address

3046 Knights Rd
Bensalem, PA 19020
Phone (215) 639-4500

Other identifiers 1

IdentifierTypeStateIssuer
0172666301MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20080908000029 PA Part B Supplier - Clinic/Group Practice 1557437035 Receives reassigned benefits from 7 practitioners
Practice locations: Bensalem, PA; Philadelphia, PA
O20090320000277 NJ Part B Supplier - Clinic/Group Practice 1557437035 Receives reassigned benefits from 6 practitioners
Practice locations: Hamilton, NJ
O20100930097757 PA DME Supplier - Physician - OptometristDME Supplier - Physician - Ophthalmology 1557437035 Practice locations: Bensalem, PA

National Provider Directory

National Provider Directory
Tax ID family
I Chaudhry MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1725 Klockner Rd
Trenton, NJ 08619
Phone (609) 586-6700

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2075747Ic Laser Eye Care, PC3046 Knights Road, Bensalem, PA 19020Certificate of waiverApr 3, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Ic Laser Eye Care, P.C.3046 Knights Rd, Bensalem, PA 19020-2815(215) 639-4500 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Aug 4, 2008

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578009600000",
    "number": "1295826485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3046 KNIGHTS RD",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "19020",
            "telephone_number": "215-639-4500",
            "fax_number": "215-604-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3046 KNIGHTS RD",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "19020",
            "telephone_number": "215-639-4500",
            "fax_number": "215-604-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IC LASER EYE CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A",
        "authorized_official_last_name": "CHAUDHRY",
        "authorized_official_first_name": "AISHA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "215-639-4500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD056677L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0172666301",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bensalem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.