Shadyside Eye Associates. LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG001865 Issued in PA

Legal business name

SHADYSIDE EYE ASSOCIATES. LLC

Practice address

5730 Ellsworth Ave 4
Pittsburgh, PA 15232-1741

Phone

(412) 404-2626

Fax

(412) 404-2446

NPI assigned

May 23, 2013

Last updated

Aug 13, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Alicia Telega, O.D.NPI 1003988296

Title

Owner

Phone

(412) 404-2626

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alicia Nichole Telega, O.D.

  • Optometrist
  • Pittsburgh, PA
  • NPI 1003988296
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376352000000",
    "number": "1477990067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5730 ELLSWORTH AVE",
            "address_2": "SUITE 4",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152321741",
            "telephone_number": "412-404-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5730 ELLSWORTH AVE 4",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152321741",
            "telephone_number": "412-404-2626",
            "fax_number": "412-404-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADYSIDE EYE ASSOCIATES. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-23",
        "last_updated": "2013-08-13",
        "status": "A",
        "authorized_official_last_name": "TELEGA",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "412-404-2626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Kingsley Shadduck, MD
• Daniel Anthony Shade Jr., MD
• Shady Med Inc (AccuServ Pharmacy-PGH)
• Shadyside Cardiology Rotation PC
• Shadyside Cardiovascular, PLLC
• Shadyside Nursing and Rehabilitation Center-Pittsburgh PA, LLC (ProMedica Skilled Nursing and Rehabilitation (Shadyside))
• Shadyside Optical Associates LLC
• Shadyside Psychological Services
• Shadyside SNF Healthcare LLC (Ivy Park Post Acute)
• Shadyside Surgi-Center, Inc.

• Optometrist in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; 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.