Active NPI
Henry Joseph Nealis, MD
- Ophthalmology Physician
- Bryn Mawr, PA
National Provider Identifier
1376593988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- MD028359L
- Practice address
- 875 County Line Rd
Ste 202
Bryn Mawr, PA 19010-3113 - Phone
- (610) 527-1133
- Fax
- (610) 527-6449
- NPI assigned
- May 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | MD028359L | PA | Primary |
Addresses
Primary practice location
875 County Line Rd
Ste 202
Bryn Mawr, PA 19010-3113
Mailing address
875 County Line Rd
Ste 202
Bryn Mawr, PA 19010-3113
Phone (610) 527-1133
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17797 | Other | PA | BS |
| 0045445000 | Other | PA | KEYSTONE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD028359L | PA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200528000000",
"number": "1376593988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "875 COUNTY LINE RD",
"address_2": "STE 202",
"city": "BRYN MAWR",
"state": "PA",
"postal_code": "190103113",
"telephone_number": "610-527-1133",
"fax_number": "610-527-6449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "875 COUNTY LINE RD",
"address_2": "STE 202",
"city": "BRYN MAWR",
"state": "PA",
"postal_code": "190103113",
"telephone_number": "610-527-1133",
"fax_number": "610-527-6449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEALIS",
"first_name": "HENRY",
"middle_name": "JOSEPH",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-12",
"last_updated": "2008-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "PA",
"license": "MD028359L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BS",
"identifier": "17797",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE",
"identifier": "0045445000",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bryn Mawr, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.