Organization Active NPI

Louis X Santore MD PC

  • Ophthalmology Physician
  • Wynnewood, PA
National Provider Identifier
1366616625
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD02689E Issued in PA
Legal business name
LOUIS X SANTORE MD PC
Practice address
100 E Lancaster Ave
Suite 36W
Wynnewood, PA 19096-3450
Phone
(610) 642-4392
Fax
(610) 642-1948
NPI assigned
Apr 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Authorized official

Name
Dr. Louis X Santore, M.D.NPI 1548209166
Title
Ophthalmologist
Phone
(610) 642-4392

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X MD02689E PA Primary

Addresses

Primary practice location

100 E Lancaster Ave
Suite 36W
Wynnewood, PA 19096-3450

Mailing address

100 E Lancaster Ave
Suite 36W
Wynnewood, PA 19096-3450
Phone (610) 642-4392

Other identifiers 3

IdentifierTypeStateIssuer
4088621OtherPAAETNA
2084353OtherPAHIGHMARK BLUE CROSS/BLUE SHIELD
3687038000OtherPAINDEPENDENCE BLUE CROSS/BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090202000041 PA Part B Supplier - Clinic/Group Practice 1456415736 Receives reassigned benefits from 1 practitioner
Practice locations: Wynnewood, PA

National Provider Directory

National Provider Directory

Locations

100 E Lancaster Ave
Ste 36W
Wynnewood, PA 19096
Phone (610) 642-4392

100 E Lancaster Ave
Ste 400S
Wynnewood, PA 19096
Phone (610) 642-4392

100 E Lancaster Ave
Ste 400
Wynnewood, PA 19096
Phone (610) 642-4392

100 E Lancaster Ave
Ste 36
Wynnewood, PA 19096
Phone (610) 642-4392

100 E Lancaster Ave
Ste 441W
Wynnewood, PA 19096
Phone (610) 642-4392

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1366616625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "SUITE 36W",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "610-642-4392",
            "fax_number": "610-642-1948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "SUITE 36W",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "610-642-4392",
            "fax_number": "610-642-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUIS X SANTORE MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-17",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "SANTORE",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "X",
        "authorized_official_title_or_position": "OPHTHALMOLOGIST",
        "authorized_official_telephone_number": "610-642-4392",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD02689E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4088621",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE CROSS/BLUE SHIELD",
            "identifier": "2084353",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS/BLUE SHIELD",
            "identifier": "3687038000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.