Individual provider Active NPI

Paul Melvin Spivak, O.D.

  • Optometrist
  • Pittsburgh, PA
National Provider Identifier
1376649855
Registry record updated Jul 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000494 Issued in PA
Practice address
2893 W Liberty Ave
Pittsburgh, PA 15216-2619
Phone
(412) 344-8691
Fax
(412) 344-6962
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000494 PA Primary

Addresses

Primary practice location

2893 W Liberty Ave
Pittsburgh, PA 15216-2619

Mailing address

2893 W Liberty Ave
Pittsburgh, PA 15216-2619
Phone (412) 344-8691

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
I20080522000018 PA Practitioner - Optometry 6709965114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dormont Vision Center LLCGroup PAC ID 7719202340, 3 clinicians

Practice addresses (Care Compare)

2893 W Liberty Ave
Pittsburgh, PA 15216-2619
Phone (412) 344-8534

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG000494PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dormont Vision Center LLC Optometrist CurrentSince Apr 5, 2004 Accepting new patients

Locations

2893 W Liberty Ave
Pittsburgh, PA 15216
Phone (412) 344-8534

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406073600000",
    "number": "1376649855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2893 W LIBERTY AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152162619",
            "telephone_number": "412-344-8691",
            "fax_number": "412-344-6962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2893 W LIBERTY AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152162619",
            "telephone_number": "412-344-8691",
            "fax_number": "412-344-6962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIVAK",
        "first_name": "PAUL",
        "middle_name": "MELVIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2014-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.