Active NPI
Theodora Betsy Cozan, OD
- Optometrist
- Exton, PA
National Provider Identifier
1316169766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 0E007863P
- Practice address
- 442 West Lincoln Highway
Exton, PA 19341 - Phone
- (610) 363-8060
- Fax
- (610) 594-8448
- NPI assigned
- May 3, 2007
- Sex
- Female
- 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 | 0E007863P | PA | Primary |
Addresses
Primary practice location
442 West Lincoln Highway
Exton, PA 19341
Mailing address
445 Saybrook Lane
Wallingford, PA 19086
Phone (610) 876-9416
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0167173415 | Medicaid | PA |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0E007863P | PA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Philadelphia Vision Center of Exton | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Eyewear Supplier
- Exton, PA
- NPI 1700099330
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316169766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "445 SAYBROOK LANE",
"city": "WALLINGFORD",
"state": "PA",
"postal_code": "19086",
"telephone_number": "610-876-9416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "442 WEST LINCOLN HIGHWAY",
"city": "EXTON",
"state": "PA",
"postal_code": "19341",
"telephone_number": "610-363-8060",
"fax_number": "610-594-8448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COZAN",
"first_name": "THEODORA",
"middle_name": "BETSY",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "0E007863P",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0167173415",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Exton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.