NPIMap

Organization Active NPI

Vision Innovation Centers of Pennsylvania LLC

  • Durable Medical Equipment & Medical Supplies
  • Peckville, PA
National Provider Identifier
1407426778
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
VISION INNOVATION CENTERS OF PENNSYLVANIA LLC
Practice address
1582 Main St
Peckville, PA 18452-2029
Phone
(570) 489-4430
NPI assigned
Jun 29, 2021
Last updated
Apr 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Authorized official

Name
Michael C Pascetta
Title
Cfo
Phone
(860) 652-5002

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary
Optician 156FX1800X NU
Ophthalmology Physician 207W00000X NU

Addresses

Primary practice location

1582 Main St
Peckville, PA 18452-2029

Mailing address

703 Rutter Ave
Kingston, PA 18704-4801
Phone (410) 571-8733

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211018000527 PA DME Supplier - Physician - Optometrist 0840625349 Practice locations: Peckville, PA

Other NPIs with the same Medicare PAC ID 20

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 20

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Vision Innovation Centers of Pennsy1582 Main St, Peckville, PA 18452-2029(570) 489-4430 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 2020

National Provider Directory

National Provider Directory
Tax ID family
Vision Innovation Centers of PA LLC16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775692800000",
    "number": "1407426778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 RUTTER AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187044801",
            "telephone_number": "410-571-8733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1582 MAIN ST",
            "city": "PECKVILLE",
            "state": "PA",
            "postal_code": "184522029",
            "telephone_number": "570-489-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION INNOVATION CENTERS OF PENNSYLVANIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-29",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A",
        "authorized_official_last_name": "PASCETTA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "860-652-5002"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peckville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.