Jeffrey David Boehme, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG000653 Issued in PA

Practice address

6305 Library Rd
South Park, PA 15129-8502

Phone

(412) 854-4130

Fax

(412) 854-8175

NPI assigned

Oct 4, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allegheny Vision AssociatesGroup PAC ID 9931147790, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Allegheny Vision Associates

  • Optometrist
  • South Park, PA
  • NPI 1104848597
  Medicare reassignment Care Compare group NPD
• Community Eye Care Associates

  • Optometrist
  • West Mifflin, PA
  • NPI 1902825086
  Medicare reassignment NPD
• Community Eye Care Associates

  • Optometrist
  • Monongahela, PA
  • NPI 1528087608
  NPD (past)

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1477540433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 HAYS RD",
            "city": "VENETIA",
            "state": "PA",
            "postal_code": "153671001",
            "telephone_number": "724-941-3404",
            "fax_number": "412-655-6513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6305 LIBRARY RD",
            "city": "SOUTH PARK",
            "state": "PA",
            "postal_code": "151298502",
            "telephone_number": "412-854-4130",
            "fax_number": "412-854-8175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHME",
        "first_name": "JEFFREY",
        "middle_name": "DAVID",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410036489",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1725156 02",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allegheny Vision Associates
• Zelda Lei Antantis
• David J Boehme, O.D.
• Hannah Elizabeth Bowersox, OTR/L
• Emily Breisinger, MS, OTR/L
• Anita Christie, ATC, RN
• Alora Taylor Dandrea, LCSW
• Dawn Marie Friend, PSYD, LLC

• Optometrist in South Park, PA
• Providers in South Park, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.