Individual provider Active NPI

Sukumar Pandit, OD

  • Optometrist
  • King of Prussia, PA
National Provider Identifier
1366487118
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG 002556 Issued in PA
Practice address
1150 1St Ave
Suite 805
King of Prussia, PA 19406-1334
Phone
(484) 681-2249
Fax
(484) 681-2250
NPI assigned
Jun 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12928 TPA CA
Optometrist 152W00000X OEG 002556 PA Primary

Addresses

Primary practice location

1150 1St Ave
Suite 805
King of Prussia, PA 19406-1334

Mailing address

1150 1St Ave
Suite 805
King of Prussia, PA 19406-1334
Phone (484) 681-2249

Other identifiers 1

IdentifierTypeStateIssuer
1366487118MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, GA, NY, TX4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20120103000724 PA Practitioner - Optometry 1254344997 Reassigns benefits to 1 organization
I20200623001916 GA Practitioner - Optometry 1254344997 Reassigns benefits to 1 organization
I20210622000679 NY Practitioner - Optometry 1254344997 Reassigns benefits to 1 organization
I20220103000328 TX Practitioner - Optometry 1254344997

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2003
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

535 Manchester Ave
Media, PA 19063-3901

Hospital & facility affiliations

  • Bassett Healthcare Hospital, Cooperstown, NY, CCN 330136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12928 TPACAMDOptometrist
OEG 002556PAMDOptometrist
12928CAMDPediatric Occupational Therapist
10113TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Apr 20, 2025 Accepting new patients
Emerging Vision Inc Optometrist CurrentSince Apr 1, 2021 Accepting new patients
Emerging Vision Inc Optometrist CurrentSince Apr 1, 2021 Accepting new patients
Valley Center Optometry Apc Optometrist CurrentSince Aug 1, 2008 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Apr 20, 2025 Accepting new patients
Small Town Eyecare Partners, LLC Optometrist CurrentSince Jun 5, 2020 Accepting new patients
Luxottica of America Inc. Past Accepting new patients
Onsight Health Care LLC Optometrist Past Accepting new patients
Onsight Health Care, LLC Past Accepting new patients
Arthur Dean Sperow, D.M.D., PLLC Past Accepting new patients

Locations

29115 Valley Center Rd
Ste E
Valley Center, CA 92082
Phone (760) 751-8771

921 Moores Ferry Rd
Ste C
Villa Rica, GA 30180
Phone (678) 460-0498

6081 State Route 96
Ste 8
Farmington, NY 14425
Phone (585) 924-2550

100 Quentin Roosevelt Blvd
Ste 101
Garden City, NY 11530

Organizations & group practices 10

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1366487118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 1ST AVE",
            "address_2": "SUITE 805",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061334",
            "telephone_number": "484-681-2249",
            "fax_number": "484-681-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 1ST AVE",
            "address_2": "SUITE 805",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061334",
            "telephone_number": "484-681-2249",
            "fax_number": "484-681-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDIT",
        "first_name": "SUKUMAR",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12928 TPA",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG 002556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366487118",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in King of Prussia, PA

Sources for this page

Verify at the official NPI Registry.