Individual provider Active NPI

Tom X Grudis, OPTICIAN

  • Optician
  • Scranton, PA
National Provider Identifier
1447273610
Registry record updated Feb 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Practice address
428 Spruce St
Scranton, PA 18503-1821
Phone
(570) 346-1771
Fax
(570) 346-5812
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X PA Primary

Addresses

Primary practice location

428 Spruce St
Scranton, PA 18503-1821

Mailing address

428 Spruce St
Scranton, PA 18503-1821
Phone (570) 346-1771

Other identifiers 1

IdentifierTypeStateIssuer
0498520001OtherPAMEDICARE PART B

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tom Grudis Optical Center Past Accepting new patients

Organizations & group practices 1

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1447273610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 SPRUCE ST",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185031821",
            "telephone_number": "570-346-1771",
            "fax_number": "570-346-5812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 SPRUCE ST",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185031821",
            "telephone_number": "570-346-1771",
            "fax_number": "570-346-5812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUDIS",
        "first_name": "TOM",
        "middle_name": "X",
        "credential": "OPTICIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "0498520001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.