Active NPI
Fadi Iskander, OD
- Optometrist
- Boothwyn, PA
National Provider Identifier
1538895727
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OEG003940
- Practice address
- 629 Conchester Boulevard
Boothwyn, PA 19061 - Phone
- (484) 483-2771
- NPI assigned
- Jul 28, 2022
- Last updated
- Apr 30, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OEG003940 | PA | Primary |
Addresses
Primary practice location
629 Conchester Boulevard
Boothwyn, PA 19061
Mailing address
629 Conchester Boulevard
Boothwyn, PA 19061
Phone (484) 483-2771
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OEG003940 | PA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714435200000",
"number": "1538895727",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "629 CONCHESTER BOULEVARD",
"city": "BOOTHWYN",
"state": "PA",
"postal_code": "19061",
"telephone_number": "484-483-2771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "629 CONCHESTER BOULEVARD",
"city": "BOOTHWYN",
"state": "PA",
"postal_code": "19061",
"telephone_number": "484-483-2771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISKANDER",
"first_name": "FADI",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-07-28",
"last_updated": "2024-04-30",
"certification_date": "2022-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OEG003940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boothwyn, PA
- James J Hill, D.M.D.
- Eugene Gregory Horsky II, D.C.
- Glenn Eugene Horsky, D.C.
- Beth A. Howlett, PH.D.
- IHS Acquisition XXX, Inc. (US Bioservices)
- Manoucher Jalali, MD
- Jeff Quip, Inc. (The Home Care Network, Jefferson Health System - Rehab Equipment)
- Joel S. Goldberg
- Nancy Elizabeth Jordan, PT
- Manuel T. Lim, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.