NPIMap

Organization Active NPI

Gretchen J Brewer, OD & Associates, Inc

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1386731727
Registry record updated May 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
GRETCHEN J BREWER, OD & ASSOCIATES, INC
Practice address
2329 Cottman Ave
Roosevelt Mall
Philadelphia, PA 19149
Phone
(215) 332-7228
Fax
(215) 332-9337
NPI assigned
Oct 6, 2006
Last updated
May 29, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2014

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

Authorized official

Name
Gretchen J Brewer, ODNPI 1235226671
Title
President Owner
Phone
(215) 332-7228

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

2329 Cottman Ave
Roosevelt Mall
Philadelphia, PA 19149

Mailing address

2329 Cottman Ave
Roosevelt Mall
Philadelphia, PA 19149
Phone (215) 332-7228

Other identifiers 5

IdentifierTypeStateIssuer
2051170000OtherPAKEYSTONE HEALTHPLAN EAST
GR1354192OtherPAPA BLUE SHIELD
01975355MedicaidPA
1354192OtherPAPERSONAL CHOICE BLUE CHOI
2988538OtherPWAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050419001393 PA Part B Supplier - Clinic/Group Practice 3173561255 Receives reassigned benefits from 17 practitioners
Practice locations: North Wales, PA; Philadelphia, PA

National Provider Directory

National Provider Directory

Locations

101 Montgomery Mall
#J
North Wales, PA 19454
Phone (215) 361-2400

2329 Cottman Ave
Philadelphia, PA 19149
Phone (215) 332-7228

2329 Cottman Ave
#J
Philadelphia, PA 19149
Phone (215) 332-7228

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401321600000",
    "number": "1386731727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2329 COTTMAN AVE",
            "address_2": "ROOSEVELT MALL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19149",
            "telephone_number": "215-332-7228",
            "fax_number": "215-332-9337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2329 COTTMAN AVE",
            "address_2": "ROOSEVELT MALL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19149",
            "telephone_number": "215-332-7228",
            "fax_number": "215-332-9337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRETCHEN J BREWER, OD & ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2014-05-29",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "GRETCHEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "215-332-7228",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTHPLAN EAST",
            "identifier": "2051170000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BLUE SHIELD",
            "identifier": "GR1354192",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01975355",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CHOICE BLUE CHOI",
            "identifier": "1354192",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2988538",
            "state": "PW"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2014; 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.