NPIMap

Organization Active NPI

Wyomissing Optometric Center, Inc.

  • Optometrist
  • Wyomissing, PA
National Provider Identifier
1366404345
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
WYOMISSING OPTOMETRIC CENTER, INC.
Practice address
50 Berkshire CT
Wyomissing, PA 19610-1219
Phone
(610) 374-3134
Fax
(610) 374-0484
NPI assigned
Apr 5, 2006
Last updated
Sep 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Authorized official

Name
Dr. Glenn S Corbin, O.D.NPI 1508828666
Title
President
Phone
(610) 374-3134

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X PA Primary

Addresses

Primary practice location

50 Berkshire CT
Wyomissing, PA 19610-1219

Mailing address

50 Berkshire CT
Wyomissing, PA 19610-1219
Phone (610) 374-3134

Other identifiers 13

IdentifierTypeStateIssuer
429305OtherPAHIGHMARK GROUP ID #
02525100OtherPAKEYSTONE/SEN BLUE GRP ID#
338133OtherPAHEALTH AMERICA/HEALTH ASSURANCE
0020592000OtherPAKEYSTONE EAST GROUP ID#
0020592000OtherPAAMERIHEALTH GROUP ID #
29435OtherPASPECTERA GROUP #
02525100OtherPACAPITAL BLUE CROSS GRP ID
5586009OtherPAAETNA/HMO
0020592000OtherPAINDEPENDENCE BC/BS
54384OtherPADAVIS AFFINITY
5586009OtherPAAETNA TRADITIONAL/PPO
70467OtherPAHEALTH AMERICA GRP ID #
CM6302OtherPAMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040211000407 PA Part B Supplier - Clinic/Group Practice 3274427208 Receives reassigned benefits from 10 practitioners
Practice locations: Douglasville, PA; Myerstown, PA; Wyomissing, PA
O20100930040186 PA DME Supplier - Physician - Optometrist 3274427208 1 other NPI on this enrollment
Practice locations: Wyomissing, PA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0996086Wyomissing Optometric Center50 Berkshire Court, Wyomissing, PA 19610Certificate of waiverJan 9, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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": "1144195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1366404345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 BERKSHIRE CT",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101219",
            "telephone_number": "610-374-3134",
            "fax_number": "610-374-0484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BERKSHIRE CT",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101219",
            "telephone_number": "610-374-3134",
            "fax_number": "610-374-0484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYOMISSING OPTOMETRIC CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-05",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A",
        "authorized_official_last_name": "CORBIN",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-374-3134",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK GROUP ID #",
            "identifier": "429305",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE/SEN BLUE GRP ID#",
            "identifier": "02525100",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA/HEALTH ASSURANCE",
            "identifier": "338133",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE EAST GROUP ID#",
            "identifier": "0020592000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH GROUP ID #",
            "identifier": "0020592000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA GROUP #",
            "identifier": "29435",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS GRP ID",
            "identifier": "02525100",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/HMO",
            "identifier": "5586009",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BC/BS",
            "identifier": "0020592000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS AFFINITY",
            "identifier": "54384",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA TRADITIONAL/PPO",
            "identifier": "5586009",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA GRP ID #",
            "identifier": "70467",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CM6302",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.