Jay B Tanner, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG 000400 Issued in PA

Practice address

423 3Rd Ave
Suite E
Kingston, PA 18704-5809

Phone

(570) 288-1974

Fax

(570) 288-0288

NPI assigned

Jul 26, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 2

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Eye Specialists PCGroup PAC ID 9133020589, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as group

Quality

100

Improvement activities

40

Cost

76.89

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Northeast Eye Specialists PC

  • Ophthalmology Physician
  • Hazleton, PA
  • NPI 1295735389

  Optometrist, PA

  Medicare reassignment Care Compare group NPD
• Northeast Eye Specialists, PC

  • Durable Medical Equipment & Medical Supplies
  • Kingston, PA
  • NPI 1255676458

  Optometrist

  Care Compare group NPD

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1528068145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 3RD AVE",
            "address_2": "SUITE E",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045809",
            "telephone_number": "570-288-1974",
            "fax_number": "570-288-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 3RD AVE",
            "address_2": "SUITE E",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045809",
            "telephone_number": "570-288-1974",
            "fax_number": "570-288-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "JAY",
        "middle_name": "B",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG 000400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA-RRMC",
            "identifier": "410043623",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011040000005",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011040000003",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtanner@directaddress.net",
            "affiliation": "N",
            "address_1": "423 3rd Ave",
            "address_2": "Suite E",
            "city": "Kingston",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187045809",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtanner@directaddress.net",
            "affiliation": "N",
            "address_1": "1060 N Church St",
            "city": "Hazle Township",
            "state": "PA",
            "country_code": "US",
            "postal_code": "182021444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashley Nicole Swantek, PTA
• Lorraine A Symons, PTA
• Robert George Szulborski, MD
• Joseph J Szustak, DO
• Joseph James Tabit
• Stephanie Ann Tanona, FNP-C
• Paul Thomas Taren, PH.D.
• Christy Taylor, PHARMD
• The Hearing Center of Northeast Pennsylvania LLC
• The Milton S. Hershey Medical Center Physician Group

• All providers in Kingston, PA
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.