Individual provider Active NPI

John Nickolas Psaltis, OD

  • Optometrist
  • Greenville, DE
National Provider Identifier
1346327301
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
I30001211OS Issued in DE
Practice address
3801 Kennett Pike Ste A102
Greenville, DE 19807-2307
Phone
(302) 777-4794
Fax
(302) 777-4872
NPI assigned
Nov 1, 2006
Last updated
Nov 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X G000697PA PA
Optometrist 152W00000X I30001211OS DE Primary

Addresses

Primary practice location

3801 Kennett Pike Ste A102
Greenville, DE 19807-2307

Mailing address

3801 Kennett Pike Ste A102
Wilmington, DE 19807-2307
Phone (302) 777-4794

Other identifiers 2

IdentifierTypeStateIssuer
0000553722MedicaidDE
G01011OtherDEGROUP MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20110330000438 DE Practitioner - Optometry 1658390786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3801 Kennett Pike
Suite A102
Greenville, DE 19807-2307
Phone (302) 777-4794

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I30001211OSDEMDOptometrist
G000697PAPAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Eye Associates PA Optometrist CurrentSince Sep 1, 2002 Accepting new patients

Locations

1301 N Harrison St
Ste 105
Wilmington, DE 19806
Phone (302) 777-4794

3801 Kennett Pike
Ste A102
Wilmington, DE 19807
Phone (302) 652-5767

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1346327301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 KENNETT PIKE STE A102",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198072307",
            "telephone_number": "302-777-4794",
            "fax_number": "302-777-4872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 KENNETT PIKE STE A102",
            "city": "GREENVILLE",
            "state": "DE",
            "postal_code": "198072307",
            "telephone_number": "302-777-4794",
            "fax_number": "302-777-4872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PSALTIS",
        "first_name": "JOHN",
        "middle_name": "NICKOLAS",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "G000697PA",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "DE",
            "license": "I30001211OS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000553722",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "G01011",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, DE

Sources for this page

Verify at the official NPI Registry.