Individual provider Active NPI

Breezy Jane Moyer, O.D.

  • Optometrist
  • Mifflinburg, PA
National Provider Identifier
1487850210
Registry record updated Jan 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001933 Issued in PA
Practice address
88 Hardees Dr
Mifflinburg, PA 17844-7062
Phone
(570) 966-3000
NPI assigned
Jun 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG001933 PA Primary

Addresses

Primary practice location

88 Hardees Dr
Mifflinburg, PA 17844-7062

Mailing address

137 JPM Rd
Lewisburg, PA 17837-9313
Phone (570) 523-3937

Other identifiers 4

IdentifierTypeStateIssuer
50083510OtherCAPITAL BLUE
118325OtherBLUE SHIELD
825611OtherFIRST PRIORITY HEALTH
113532OtherGEISINGER

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
I20071120000269 PA Practitioner - Optometry 5890889117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

102 Quail LN
Suite 2
Mifflinburg, PA 17844-9325
Phone (570) 966-0101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG001933PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myoptik Optometrist CurrentSince Jul 1, 2019 Accepting new patients

Locations

102 Quail Ln
Ste 2
Mifflinburg, PA 17844
Phone (570) 966-0101

Organizations & group practices 1

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": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296432000000",
    "number": "1487850210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 JPM RD",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178379313",
            "telephone_number": "570-523-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 HARDEES DR",
            "city": "MIFFLINBURG",
            "state": "PA",
            "postal_code": "178447062",
            "telephone_number": "570-966-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYER",
        "first_name": "BREEZY",
        "middle_name": "JANE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2011-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE",
            "identifier": "50083510",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "118325",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "825611",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "113532",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mifflinburg, PA

Sources for this page

Verify at the official NPI Registry.