Individual provider Active NPI

John Joseph Glasner IV, O.D.

  • Corneal and Contact Management Optometrist
  • Stroudsburg, PA
National Provider Identifier
1487817896
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
OEG-002146 Issued in PA
Practice address
208 Main St
Stroudsburg, PA 18360-2575
Phone
(570) 369-3139
NPI assigned
Jul 7, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1523 SC
Corneal and Contact Management Optometrist 152WC0802X OEG-002146 PA Primary

Addresses

Primary practice location

208 Main St
Stroudsburg, PA 18360-2575

Mailing address

208 Main St
Stroudsburg, PA 18360-2575
Phone (570) 476-1114

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
I20090522000378 PA Practitioner - Optometry 4284783135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

208 Main St
Stroudsburg, PA 18360-2575
Phone (570) 476-1114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1523SCMDOptometrist
OEG-002146PAMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony S. Diecidue P.C. Optometrist CurrentSince Apr 20, 2009 Accepting new patients
Personaltouronline,Inc. Optometrist Past Accepting new patients
Special Care Vision Inc Optometrist Past Accepting new patients
Anthony S. Diecidue, P.C. Optometrist Past Accepting new patients

Locations

2571 Route 6
Ste 1
Hawley, PA 18428
Phone (570) 226-2400

1421 Main St
Peckville, PA 18452
Phone (570) 382-3922

208 Main St
Stroudsburg, PA 18360
Phone (570) 369-3139

Organizations & group practices 5

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": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1487817896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 MAIN ST",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183602575",
            "telephone_number": "570-476-1114",
            "fax_number": "570-476-9520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 MAIN ST",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183602575",
            "telephone_number": "570-369-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASNER",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1523",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "PA",
            "license": "OEG-002146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stroudsburg, PA

Sources for this page

Verify at the official NPI Registry.