Individual provider Active NPI

Jordan T Cook, OD

  • Optometrist
  • Sayre, PA
National Provider Identifier
1306335856
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003428 Issued in PA
Practice address
1 Guthrie SQ
Sayre, PA 18840-1625
Phone
(570) 887-3241
Fax
(570) 887-3236
NPI assigned
May 9, 2018
Last updated
Mar 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X PENDING PA
Optometrist 152W00000X TUV008846 NY
Optometrist 152W00000X OEG003428 PA Primary

Addresses

Primary practice location

1 Guthrie SQ
Sayre, PA 18840-1625

Mailing address

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180802002143 PA Practitioner - Optometry 8123376431 Reassigns benefits to 1 organization
I20180815002810 NY Practitioner - Optometry 8123376431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guthrie Medical Group PCGroup PAC ID 6002728656, shared by 5 NPIs, 795 clinicians

Practice addresses (Care Compare)

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858

130 Ctr Way
Corning, NY 14830-2255
Phone (607) 936-9971

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PENDINGPAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. CurrentSince Aug 1, 2018 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Aug 1, 2018 Accepting new patients
Guthrhie Medical Group, P.C. Optometrist CurrentSince Aug 1, 2018 Accepting new patients
Guthrie Medical Group, P.C. Current Accepting new patients
Guthrie Medical Group PC Past Accepting new patients

Locations

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Interoperability endpoints

  • Direct secure messaging: jcook138970@direct-guthrie.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1306335856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-887-3241",
            "fax_number": "570-887-3236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "JORDAN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-09",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008846",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sayre, PA

Sources for this page

Verify at the official NPI Registry.