Myeyedr Optometry of Pennsylvania, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MYEYEDR OPTOMETRY OF PENNSYLVANIA, LLC

Doing business as

MyEyeDr.

Practice address

2 Briarcrest SQ
Hershey, PA 17033-2359

Phone

(717) 533-2362

Fax

(717) 534-2357

NPI assigned

Oct 24, 2022

Last updated

Oct 24, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sue Downes

Title

Secretary

Phone

(703) 847-8899

Specialties & licenses 1

Addresses

Other names 1

• MyEyeDr. Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666569600000",
    "number": "1437876224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BRIARCREST SQ",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332359",
            "telephone_number": "717-533-2362",
            "fax_number": "717-534-2357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYEYEDR OPTOMETRY OF PENNSYLVANIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A",
        "authorized_official_last_name": "DOWNES",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "703-847-8899"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyEyeDr.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Swathi Muttana, MD
• Brenda Waceke Mwangi, PA-C
• Abigail Kate Myers, M.D.
• John L Myers, MD
• Tiffany Myers, LDN
• Conrad Spencer Myler, M.D.
• Gerald V Naccarelli, MD
• Reli Naco, DMD
• Luis L. Nadal, M.D.
• Nandakumar Nagaraja, M.D., M.S.

• Optometrist in Hershey, PA
• Providers in Hershey, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.