Individual provider Active NPI

Marie T. Homa-Palladino, O.D.

  • Optometrist
  • Paoli, PA
National Provider Identifier
1407955230
Registry record updated Aug 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG002034 Issued in PA
Practice address
1776 E Lancaster Ave
2
Paoli, PA 19301-1550
Phone
(610) 647-2502
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG002034 PA Primary

Addresses

Primary practice location

1776 E Lancaster Ave
2
Paoli, PA 19301-1550

Mailing address

1776 E Lancaster Ave
2
Paoli, PA 19301-1550
Phone (610) 647-2502

Other identifiers 1

IdentifierTypeStateIssuer
552082ZFJOtherPAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100108000204 PA Practitioner - Optometry 3577565464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moa Medical Practices PCGroup PAC ID 0941626998, 3 clinicians

Practice addresses (Care Compare)

3475 W Chester Pike
Suite 100 Moa Medical Practices PC Newtown
Newtown Square, PA 19073-4281
Phone (610) 422-7999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002677CTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Moa Medical Practices PC Optometrist CurrentSince Jun 20, 2023 Accepting new patients
Mary C. Beaulieu, OD Optometrist Past Accepting new patients

Locations

303 Horsham Rd
Ste G
Horsham, PA 19044
Phone (267) 965-2599

781 Far Hills Dr
Ste 100
New Freedom, PA 17349
Phone (571) 291-9779

3475 West Chester Pike
Ste 100
Newtown Square, PA 19073
Phone (610) 422-7999

3475 West Chester Pike
Ste 1
Newtown Square, PA 19073
Phone (610) 422-7999

633 W Germantown Pike
Ste 100A
Plymouth Meeting, PA 19462
Phone (610) 275-0660

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280880000000",
    "number": "1407955230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1776 E LANCASTER AVE",
            "address_2": "2",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011550",
            "telephone_number": "610-647-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 E LANCASTER AVE",
            "address_2": "2",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011550",
            "telephone_number": "610-647-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMA-PALLADINO",
        "first_name": "MARIE",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2010-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "552082ZFJ",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, PA

Sources for this page

Verify at the official NPI Registry.