NPIMap

Organization Active NPI

Fayette Regional Eyecare Inc

  • Optometrist
  • Uniontown, PA
National Provider Identifier
1437249786
Registry record updated Mar 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OE6001711 Issued in PA
Legal business name
FAYETTE REGIONAL EYECARE INC
Practice address
160 Wayland Smith Drive
Suite 100
Uniontown, PA 15401
Phone
(724) 437-1300
Fax
(724) 437-5456
NPI assigned
Oct 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2011

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

Authorized official

Name
Dr. Jonathan Edward Ross, ODNPI 1538150578
Title
Optometrist -Owner/President/Secret
Phone
(724) 437-1300

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X OEG001664 PA
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X OEG001711 PA
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X OE6001711 PA Primary

Addresses

Primary practice location

160 Wayland Smith Drive
Suite 100
Uniontown, PA 15401

Mailing address

160 Wayland Smith Drive
Suite 100
Uniontown, PA 15401
Phone (724) 437-1300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061207000153 PA Part B Supplier - Clinic/Group Practice 4486653128 Receives reassigned benefits from 1 practitioner
Practice locations: Uniontown, PA

National Provider Directory

National Provider Directory

Locations

82 McClellandtown Rd
Uniontown, PA 15401
Phone (724) 437-1300

160 Wayland Smith Dr
Ste 100
Uniontown, PA 15401
Phone (724) 437-1300

Practitioners & affiliated clinicians

Practitioners 3

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": "1160784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299801600000",
    "number": "1437249786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 WAYLAND SMITH DRIVE",
            "address_2": "SUITE 100",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "15401",
            "telephone_number": "724-437-1300",
            "fax_number": "724-437-5456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 WAYLAND SMITH DRIVE",
            "address_2": "SUITE 100",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "15401",
            "telephone_number": "724-437-1300",
            "fax_number": "724-437-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTE REGIONAL EYECARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-14",
        "last_updated": "2011-03-11",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OPTOMETRIST -OWNER/PRESIDENT/SECRET",
        "authorized_official_telephone_number": "724-437-1300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001664",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001711",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OE6001711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Uniontown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2011; 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.