Individual provider Active NPI

Jasmine Quintana Avila

  • Optometrist
  • Scranton, PA
National Provider Identifier
1487549069
Registry record updated Jul 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG004280 Issued in PA
Practice address
1402 Washburn St
Scranton, PA 18504-2429
Phone
(570) 343-2591
NPI assigned
Jun 12, 2025
Last updated
Jul 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG004280 PA Primary

Addresses

Primary practice location

1402 Washburn St
Scranton, PA 18504-2429

Mailing address

213 S Sumner Ave
Scranton, PA 18504-2579
Phone (570) 468-6553

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
I20250909002427 PA Practitioner - Optometry 1951803709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Group practices
Ohora Eye Care Center IncGroup PAC ID 9537132105, 3 clinicians

Practice addresses (Care Compare)

602 S State St
Clarks Summit, PA 18411-1704
Phone (570) 586-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG004280PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ohora Eye Care Center Inc Optometrist CurrentSince Aug 11, 2025 Accepting new patients
Ohora Eye Care Center Inc PastSince Aug 11, 2025 Accepting new patients

Locations

602 S State St
Clarks Summit, PA 18411
Phone (570) 586-2020

1402 Washburn St
Scranton, PA 18504
Phone (570) 343-2591

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": "1749686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752278400000",
    "number": "1487549069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S SUMNER AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185042579",
            "telephone_number": "570-468-6553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 WASHBURN ST",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185042429",
            "telephone_number": "570-343-2591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTANA AVILA",
        "first_name": "JASMINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-12",
        "last_updated": "2025-07-12",
        "certification_date": "2025-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG004280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.