Organization Active NPI

Vision Innovation Centers of Pennsylvania LLC

  • Durable Medical Equipment & Medical Supplies
  • Honesdale, PA
National Provider Identifier
1477123743
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
VISION INNOVATION CENTERS OF PENNSYLVANIA LLC
Practice address
626 Park St
Honesdale, PA 18431-1446
Phone
(570) 253-1720
NPI assigned
Jun 29, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Authorized official

Name
Michael Pascetta
Title
Cfo
Phone
(860) 652-5002

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193200000X MULTI-SPECIALTY GROUP 156FX1800X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

626 Park St
Honesdale, PA 18431-1446

Mailing address

703 Rutter Ave
Kingston, PA 18704-4801
Phone (410) 571-8733

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211018000353 PA DME Supplier - Physician - Optometrist 0840625349 Practice locations: Honesdale, PA

Other NPIs with the same Medicare PAC ID 20

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 20

National Provider Directory

National Provider Directory
Tax ID family
Vision Innovation Centers of Pennsylvania LLC16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

650 Old Willow Ave
#6
Honesdale, PA 18431

NPI Registry JSON

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775692800000",
    "number": "1477123743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 RUTTER AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187044801",
            "telephone_number": "410-571-8733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 PARK ST",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184311446",
            "telephone_number": "570-253-1720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION INNOVATION CENTERS OF PENNSYLVANIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-29",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A",
        "authorized_official_last_name": "PASCETTA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "860-652-5002"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honesdale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.