Organization Active NPI

Jason Pittser OD Inc.

  • Optometrist
  • Wilmington, OH
National Provider Identifier
1306925672
Registry record updated Aug 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5143 Issued in OH
Legal business name
JASON PITTSER OD INC.
Practice address
87 Fairway Dr
#125
Wilmington, OH 45177
Phone
(937) 382-2433
Fax
(937) 383-6619
NPI assigned
Nov 6, 2006
Last updated
Aug 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2013

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

Authorized official

Name
Jennifer Lynn Morgan
Title
Insurance Rep
Phone
(937) 382-2433

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5143 OH Primary

Addresses

Primary practice location

87 Fairway Dr
#125
Wilmington, OH 45177

Mailing address

87 Fairway Dr
#125
Wilmington, OH 45177
Phone (937) 382-2433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080828000348 OH Part B Supplier - Clinic/Group Practice 9234025446 Receives reassigned benefits from 3 practitioners
Practice locations: Wilmington, OH

National Provider Directory

National Provider Directory

Locations

87 Fairway Dr
Wilmington, OH 45177
Phone (930) 382-2433

87 Fairway Dr
#125
Wilmington, OH 45177
Phone (930) 382-2433

87 Fairway Dr
Ste 125
Wilmington, OH 45177
Phone (937) 382-2433

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377475200000",
    "number": "1306925672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 FAIRWAY DR",
            "address_2": "#125",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "45177",
            "telephone_number": "937-382-2433",
            "fax_number": "937-383-6619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 FAIRWAY DR",
            "address_2": "#125",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "45177",
            "telephone_number": "937-382-2433",
            "fax_number": "937-383-6619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON PITTSER OD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2013-08-26",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "INSURANCE REP",
        "authorized_official_telephone_number": "937-382-2433"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.