Individual provider Active NPI

Laverda Monique Richards, O.D.

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1497959456
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OL-049 Issued in GU
Practice address
3212 W Cheltenham Ave
Philadelphia, PA 19150-1003
Phone
(215) 885-1200
Fax
(215) 885-8807
NPI assigned
Jun 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13-0001387 DE
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X OL-049 GU Primary
Optometrist 152W00000X OE008223T PA

Addresses

Primary practice location

3212 W Cheltenham Ave
Philadelphia, PA 19150-1003

Mailing address

1316 W Chester Pike Apt C7
West Chester, PA 19382-6435
Phone (610) 761-4760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DE, GU3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20120706000461 PA Practitioner - Optometry 6800969288 Reassigns benefits to 1 organization
I20160722001058 DE Practitioner - Optometry 6800969288 Reassigns benefits to 3 organizations
I20210720002658 GU Practitioner - Optometry 6800969288 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13-0001387DEMDOptometrist
OL-049GUMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Physicians & Surgeons, PA Optometrist CurrentSince Aug 12, 2020 Accepting new patients
Eye Physicians & Surgeons, PA Optometrist CurrentSince Aug 12, 2020 Accepting new patients
General Conference Corp of Sda Multi-Specialty CurrentSince Jul 1, 2021 Accepting new patients
Simon Eye Associates PA Optometrist CurrentSince Dec 1, 2023 Accepting new patients

Locations

5301 Limestone Rd
Ste 128
Wilmington, DE 19808

912 N Union St
Wilmington, DE 19805
Phone (302) 655-8180

1207 N Scott St
Wilmington, DE 19806
Phone (302) 428-9900

Organizations & group practices 6

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": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1497959456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 W CHESTER PIKE APT C7",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193826435",
            "telephone_number": "610-761-4760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3212 W CHELTENHAM AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191501003",
            "telephone_number": "215-885-1200",
            "fax_number": "215-885-8807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "LAVERDA",
        "middle_name": "MONIQUE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "DE",
            "license": "13-0001387",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "GU",
            "license": "OL-049",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OE008223T",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.