Individual provider Active NPI

John J Schietroma, MD

  • Ophthalmology Physician
  • Harrisburg, PA
National Provider Identifier
1447248992
Registry record updated Dec 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD027344E Issued in PA
Practice address
4700 Union Deposit Rd
Ste 230
Harrisburg, PA 17111-3774
Phone
(717) 541-9700
Fax
(717) 541-9705
NPI assigned
Oct 10, 2005
Last updated
Dec 7, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD027344E PA Primary

Addresses

Primary practice location

4700 Union Deposit Rd
Ste 230
Harrisburg, PA 17111-3774

Mailing address

4700 Union Deposit Rd
Ste 230
Harrisburg, PA 17111-3774
Phone (717) 541-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD027344EPAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pennsylvania Retina Specialists PC Ophthalmology Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354838400000",
    "number": "1447248992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 UNION DEPOSIT RD",
            "address_2": "STE 230",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171113774",
            "telephone_number": "717-541-9700",
            "fax_number": "717-541-9705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 UNION DEPOSIT RD",
            "address_2": "STE 230",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171113774",
            "telephone_number": "717-541-9700",
            "fax_number": "717-541-9705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHIETROMA",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2012-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD027344E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.