NPIMap

Organization Active NPI

Sisson - Boyer Eyecare, LLC

  • Optometrist
  • Newport, PA
National Provider Identifier
1376877704
Registry record updated Dec 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000258 Issued in PA
Legal business name
SISSON - BOYER EYECARE, LLC
Practice address
7 Cramer Dr
Newport, PA 17074-8720
Phone
(717) 567-3103
NPI assigned
Oct 2, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2010

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

Authorized official

Name
Mrs. Suzanne R. Gingrich
Title
Billing Manager
Phone
(717) 567-3103

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X OEG000258 PA Primary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X OEG000253 PA

Addresses

Primary practice location

7 Cramer Dr
Newport, PA 17074-8720

Mailing address

7 Cramer Dr
PO Box 70
Newport, PA 17074-8720
Phone (717) 567-3103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101026000810 PA Part B Supplier - Clinic/Group Practice 3173716826 Receives reassigned benefits from 5 practitioners
Practice locations: Newport, PA

National Provider Directory

National Provider Directory

Locations

300 Bretz Ct
Ste 200
Newport, PA 17074
Phone (717) 567-3103

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1254441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292803200000",
    "number": "1376877704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CRAMER DR",
            "address_2": "PO BOX 70",
            "city": "NEWPORT",
            "state": "PA",
            "postal_code": "170748720",
            "telephone_number": "717-567-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 CRAMER DR",
            "city": "NEWPORT",
            "state": "PA",
            "postal_code": "170748720",
            "telephone_number": "717-567-3103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISSON - BOYER EYECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-02",
        "last_updated": "2010-12-20",
        "status": "A",
        "authorized_official_last_name": "GINGRICH",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "717-567-3103",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000258",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000253",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.