Individual provider Active NPI

Marissa Soisson, O.D.

  • Optometrist
  • Connellsville, PA
National Provider Identifier
1366999641
Registry record updated Sep 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003217 Issued in PA
Practice address
211 E Georgia Ave
Connellsville, PA 15425-2247
Phone
(724) 628-1373
NPI assigned
Sep 5, 2016
Last updated
Sep 5, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003217 PA Primary

Addresses

Primary practice location

211 E Georgia Ave
Connellsville, PA 15425-2247

Mailing address

211 E Georgia Ave
Connellsville, PA 15425-2247

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
I20170127001603 PA Practitioner - Optometry 5294017208 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2329 Cottman Ave
Philadelphia, PA 19149-1003

289 Perrysville Rd
Saltsburg, PA 15681-3292

3070 Bristol Pike
Suite 2 220
Bensalem, PA 19020-5361

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gretchen J Brewer, OD & Associates, Inc Optometrist CurrentSince Dec 1, 2016 Accepting new patients
Alpha Optical Doylestown, LLC Optometrist CurrentSince Jul 1, 2018 Accepting new patients

Locations

73 Old Dublin Pike
Ste 13C
Doylestown, PA 18901
Phone (215) 230-4060

101 Montgomery Mall
#J
North Wales, PA 19454
Phone (215) 361-2400

2329 Cottman Ave
Philadelphia, PA 19149
Phone (215) 332-7228

2329 Cottman Ave
#J
Philadelphia, PA 19149
Phone (215) 332-7228

Organizations & group practices 3

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": "1473033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473033600000",
    "number": "1366999641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E GEORGIA AVE",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154252247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E GEORGIA AVE",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154252247",
            "telephone_number": "724-628-1373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOISSON",
        "first_name": "MARISSA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-05",
        "last_updated": "2016-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Connellsville, PA

Sources for this page

Verify at the official NPI Registry.