Individual provider Active NPI

Jerard W Brown, OD

  • Optometrist
  • Kingston, PA
National Provider Identifier
1376539916
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG1338 Issued in PA
Practice address
703 Rutter Ave
Kingston, PA 18704-4801
Phone
(570) 288-7405
Fax
(570) 288-7406
NPI assigned
Sep 20, 2005
Last updated
Sep 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG1338 PA Primary

Addresses

Primary practice location

703 Rutter Ave
Kingston, PA 18704-4801

Mailing address

2661 Riva Rd Ste 1030
Annapolis, MD 21401-7131
Phone (410) 571-8733

Other identifiers 2

IdentifierTypeStateIssuer
BR1691698OtherPAHIGHMARK BLUE SHIELD
0016537180006MedicaidPA

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
I20050428000473 PA Practitioner - Optometry 4082653118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

170 Boston Ave
West Pittston, PA 18643-2724
Phone (570) 602-1010

703 Rutter Ave
Kingston, PA 18704-4801
Phone (570) 288-7405

Merit-based Incentive Payment System (MIPS)

Final score
85.08 of 100Reported as group
Quality
85.29
Promoting interoperability
100
Improvement activities
40
Cost
64.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG1338PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Innovation Centers of PA LLC CurrentSince Aug 1, 2021 Accepting new patients
Vision Innovation Centers of Pennsylvania LLC Optometrist CurrentSince Aug 1, 2021 Accepting new patients
Vision Innovation Centers of Pennsylvania LLC Optometrist Current Accepting new patients

Locations

2661 Riva Rd
Ste 1030
Annapolis, MD 21401

40 Dallas Village Shopping Ctr
Dallas, PA 18612
Phone (570) 674-9001

703 Rutter Ave
Kingston, PA 18704
Phone (570) 288-7405

200 Mifflin Ave
Scranton, PA 18503
Phone (570) 342-3145

170 Boston Ave
West Pittston, PA 18643
Phone (570) 602-1010

679 Kidder St
Wilkes Barre Township, PA 18702
Phone (570) 704-0300

Interoperability endpoints

  • Direct secure messaging: jerard.brown@vip.emadirect.md

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1376539916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2661 RIVA RD STE 1030",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017131",
            "telephone_number": "410-571-8733",
            "fax_number": "410-571-6309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 RUTTER AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187044801",
            "telephone_number": "570-288-7405",
            "fax_number": "570-288-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JERARD",
        "middle_name": "W",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG1338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "BR1691698",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016537180006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, PA

Sources for this page

Verify at the official NPI Registry.