Individual provider Active NPI

John Allen Reimold Jr., OD

  • Optometrist
  • Greenville, PA
National Provider Identifier
1366442808
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000629 Issued in PA
Practice address
59 Hadley Rd
Ste a
Greenville, PA 16125-1219
Phone
(724) 588-3322
Fax
(724) 588-3552
NPI assigned
Jul 27, 2005
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 OEG000629 PA Primary

Addresses

Primary practice location

59 Hadley Rd
Ste a
Greenville, PA 16125-1219

Mailing address

59 Hadley Rd
Ste a
Greenville, PA 16125-1219
Phone (724) 588-3322

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
I20040408000012 PA Practitioner - Optometry 0941197297 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Eye Center, Inc. Optometrist CurrentSince May 3, 2021 Accepting new patients

Locations

644 Merchant St
Ambridge, PA 15003
Phone (724) 266-2639

59 Hadley Rd
Ste A
Greenville, PA 16125
Phone (724) 588-3322

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.

NPI Registry JSON

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366442808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 HADLEY RD",
            "address_2": "STE A",
            "city": "GREENVILLE",
            "state": "PA",
            "postal_code": "161251219",
            "telephone_number": "724-588-3322",
            "fax_number": "724-588-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 HADLEY RD",
            "address_2": "STE A",
            "city": "GREENVILLE",
            "state": "PA",
            "postal_code": "161251219",
            "telephone_number": "724-588-3322",
            "fax_number": "724-588-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIMOLD",
        "first_name": "JOHN",
        "middle_name": "ALLEN",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, PA

Sources for this page

Verify at the official NPI Registry.