Individual provider Active NPI

Scott William Sanders, O.D.

  • Optometrist
  • Erie, PA
National Provider Identifier
1306950696
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000388 Issued in PA
Practice address
4600 Buffalo Rd
Erie, PA 16510-2207
Phone
(814) 899-6498
Fax
(814) 899-3753
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000388 PA Primary

Addresses

Primary practice location

4600 Buffalo Rd
Erie, PA 16510-2207

Mailing address

4600 Buffalo Rd
Erie, PA 16510-2207
Phone (814) 899-6498

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120508000460 PA Practitioner - Optometry 8022129097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4600 Buffalo Rd
Erie, PA 16510-2207
Phone (814) 899-6498

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
680MTMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Sanders Professional Eye Care Inc. Optometrist CurrentSince Jun 8, 2009 Accepting new patients
Dr. Sanders' Professional Eyecare Optometrist CurrentSince Oct 23, 2000 Accepting new patients

Locations

4600 Buffalo Rd
Erie, PA 16510
Phone (814) 899-6498

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306950696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 BUFFALO RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165102207",
            "telephone_number": "814-899-6498",
            "fax_number": "814-899-3753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 BUFFALO RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165102207",
            "telephone_number": "814-899-6498",
            "fax_number": "814-899-3753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "SCOTT",
        "middle_name": "WILLIAM",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.