Individual provider Active NPI

John T Anzelmi, OD

  • Optometrist
  • Hazleton, PA
National Provider Identifier
1447250592
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000326 Issued in PA
Practice address
1060 N Church St
Hazleton, PA 18202-1444
Phone
(570) 459-9927
Fax
(570) 459-9923
NPI assigned
Jul 29, 2005
Last updated
Apr 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000326 PA Primary

Addresses

Primary practice location

1060 N Church St
Hazleton, PA 18202-1444

Mailing address

423 3Rd Ave
Suite E
Kingston, PA 18704-5809
Phone (570) 288-1974

Other identifiers 4

IdentifierTypeStateIssuer
0014917810005MedicaidPA
0014917810007MedicaidPA
0014917810006MedicaidPA
410044831OtherPAPALMETTO GBA-RRMC

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address janzelmi@directaddress.net
Direct Messaging Address janzelmi@directaddress.net

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
I20070517000583 PA Practitioner - Optometry 9032216551 Reassigns benefits to 1 organization
Practice locations: Freeland, PA; Old Forge, PA; Scott Township, PA

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
Northeast Eye Specialists PCGroup PAC ID 9133020589, 4 clinicians

Practice addresses (Care Compare)

1060 N Church St
Hazle Township, PA 18202-1444
Phone (570) 459-9927

423 3Rd Ave
Suite E
Kingston, PA 18704-5809
Phone (570) 288-1974

429 S Main St
Old Forge, PA 18518-1684
Phone (570) 457-7339

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as group
Quality
100
Improvement activities
40
Cost
76.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG000326PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Eye Specialists, PC Optometrist CurrentSince Oct 1, 1993 Accepting new patients
Northeast Eye Specialists PC Optometrist CurrentSince Oct 1, 1993 Accepting new patients

Locations

1060 N Church St
Hazle Township, PA 18202
Phone (570) 459-9927

423 3rd Ave
Ste E
Kingston, PA 18704
Phone (570) 288-1974

Interoperability endpoints

  • Direct secure messaging: janzelmi@directaddress.net

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": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1447250592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 3RD AVE",
            "address_2": "SUITE E",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045809",
            "telephone_number": "570-288-1974",
            "fax_number": "570-288-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 N CHURCH ST",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182021444",
            "telephone_number": "570-459-9927",
            "fax_number": "570-459-9923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANZELMI",
        "first_name": "JOHN",
        "middle_name": "T",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014917810005",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014917810007",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014917810006",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA-RRMC",
            "identifier": "410044831",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "janzelmi@directaddress.net",
            "affiliation": "N",
            "address_1": "1060 N Church St",
            "city": "Hazleton",
            "state": "PA",
            "country_code": "US",
            "postal_code": "182021444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "janzelmi@directaddress.net",
            "affiliation": "N",
            "address_1": "423 3rd Ave Ste E",
            "city": "Kingston",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187045809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hazleton, PA

Sources for this page

Verify at the official NPI Registry.