Organization Active NPI

Abraham Eye Associates LLC

  • Optometrist
  • Bryn Mawr, PA
National Provider Identifier
1396143236
Registry record updated Dec 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001858 Issued in PA
Legal business name
ABRAHAM EYE ASSOCIATES LLC
Practice address
1149 W Lancaster Ave
U5
Bryn Mawr, PA 19010-2722
Phone
(610) 572-3073
NPI assigned
Dec 9, 2014
Last updated
Dec 9, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2014

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

Authorized official

Name
Kim Miller
Title
Billing Manager
Phone
(610) 491-2125

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG001858 PA Primary

Addresses

Primary practice location

1149 W Lancaster Ave
U5
Bryn Mawr, PA 19010-2722

Mailing address

1149 W Lancaster Ave
U5
Bryn Mawr, PA 19010-2722
Phone (610) 572-3073

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150219001505 PA Part B Supplier - Clinic/Group Practice 0941525729 Receives reassigned benefits from 6 practitioners
Practice locations: Villanova, PA

National Provider Directory

National Provider Directory

Locations

1149 W Lancaster Ave
#U5
Bryn Mawr, PA 19010
Phone (610) 572-3073

100 Squire Dr
Newtown Square, PA 19073

100 Squire Dr
Ste C
Newtown Square, PA 19073

795 E Lancaster Ave
Ste 3B
Villanova, PA 19085
Phone (484) 380-3864

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418083200000",
    "number": "1396143236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1149 W LANCASTER AVE",
            "address_2": "U5",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190102722",
            "telephone_number": "610-572-3073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1149 W LANCASTER AVE",
            "address_2": "U5",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190102722",
            "telephone_number": "610-572-3073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABRAHAM EYE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-09",
        "last_updated": "2014-12-09",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "610-491-2125"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001858",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 9, 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.