Individual provider Active NPI

Yuliya Leyzerzon, O.D.

  • Optometrist
  • Fairless Hills, PA
National Provider Identifier
1376548909
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001255 Issued in PA
Practice address
453 S Oxford Valley Rd
Fairless Hills, PA 19030-4202
Phone
(215) 547-5470
Fax
(215) 547-7877
NPI assigned
Jun 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG001255 PA Primary

Addresses

Primary practice location

453 S Oxford Valley Rd
Fairless Hills, PA 19030-4202

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970

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
I20060615000206 PA Practitioner - Optometry 3173539301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Pennsylvania LLCGroup PAC ID 3971884883, 118 clinicians

Practice addresses (Care Compare)

453 S Oxford Valley Rd
Fairless Hills, PA 19030-4202
Phone (215) 547-5470

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG001255PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist CurrentSince Sep 12, 2018 Accepting new patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist CurrentSince Sep 12, 2018 Accepting new patients

Locations

453 S Oxford Valley Rd
Fairless Hills, PA 19030
Phone (215) 547-5470

451 S Oxford Valley Rd
Fairless Hls, PA 19030
Phone (215) 547-5470

125 S Antrim Way
Greencastle, PA 17225
Phone (717) 597-4780

2842 S Eagle Rd
Newtown, PA 18940
Phone (215) 579-1155

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1376548909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 S OXFORD VALLEY RD",
            "city": "FAIRLESS HILLS",
            "state": "PA",
            "postal_code": "190304202",
            "telephone_number": "215-547-5470",
            "fax_number": "215-547-7877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEYZERZON",
        "first_name": "YULIYA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-20",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairless Hills, PA

Sources for this page

Verify at the official NPI Registry.