Organization Active NPI

Central Bucks Ophthalmology, LLC

  • Ophthalmology Physician
  • Doylestown, PA
National Provider Identifier
1386784072
Registry record updated Feb 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD063813L Issued in PA
Legal business name
CENTRAL BUCKS OPHTHALMOLOGY, LLC
Practice address
410 Farm LN
The Carraige House
Doylestown, PA 18901-4740
Phone
(215) 348-4554
Fax
(215) 348-4968
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2010

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

Authorized official

Name
Dr. Kristine E Longshore, MDNPI 1952452104
Title
President
Phone
(215) 348-4554

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X MD063813L PA Primary

Addresses

Primary practice location

410 Farm LN
The Carraige House
Doylestown, PA 18901-4740

Mailing address

410 Farm LN
The Carraige House
Doylestown, PA 18901-4740
Phone (215) 348-4554

Other identifiers 4

IdentifierTypeStateIssuer
7638537OtherPAAETNA NON-HMO GROUP NUMBE
P3275675OtherPAOXFORD
3476993OtherPAAETNA HMO GROUP NUMBER
1595442OtherPABLUE SHIELD GROUP NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040628000805 PA Part B Supplier - Clinic/Group Practice 1557347788 Receives reassigned benefits from 1 practitioner
Practice locations: Doylestown, PA

National Provider Directory

National Provider Directory

Locations

410 Farm Ln
Doylestown, PA 18901
Phone (215) 348-4554

Practitioners & affiliated clinicians

Practitioners 1

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": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266451200000",
    "number": "1386784072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 FARM LN",
            "address_2": "THE CARRAIGE HOUSE",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189014740",
            "telephone_number": "215-348-4554",
            "fax_number": "215-348-4968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 FARM LN",
            "address_2": "THE CARRAIGE HOUSE",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189014740",
            "telephone_number": "215-348-4554",
            "fax_number": "215-348-4968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL BUCKS OPHTHALMOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2010-02-18",
        "status": "A",
        "authorized_official_last_name": "LONGSHORE",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-348-4554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD063813L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NON-HMO GROUP NUMBE",
            "identifier": "7638537",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3275675",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO GROUP NUMBER",
            "identifier": "3476993",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP NUMBER",
            "identifier": "1595442",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Doylestown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.