Individual provider Active NPI

Lisa M Mongiello, OD

  • Optometrist
  • Scranton, PA
National Provider Identifier
1548273600
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000231 Issued in PA
Practice address
200 Mifflin Ave
Scranton, PA 18503-1982
Phone
(570) 342-3145
Fax
(570) 344-1309
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000231 PA Primary

Addresses

Primary practice location

200 Mifflin Ave
Scranton, PA 18503-1982

Mailing address

2661 Riva Rd Ste 1030
Annapolis, MD 21401-7131
Phone (667) 354-5528

Other identifiers 6

IdentifierTypeStateIssuer
15788OtherGEISINGER HEALTH PLAN
001504280MedicaidPA
506554OtherAETNA
M0774785OtherHIGHMARK BLUE SHIELD
410032103OtherRAILROAD MEDICARE
081377OtherFIRST PRIORITY HEALTH

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
I20100303000732 PA Practitioner - Optometry 6002951928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1582 Main St
Peckville, PA 18452-2029
Phone (570) 489-4430

170 Boston Ave
West Pittston, PA 18643-2724
Phone (570) 602-1010

200 Mifflin Ave
Scranton, PA 18503-1982
Phone (855) 204-6888

Merit-based Incentive Payment System (MIPS)

Final score
85.08 of 100Reported as group
Quality
85.29
Promoting interoperability
100
Improvement activities
40
Cost
64.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG000231PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Innovation Centers of Pennsylvania LLC Optometrist CurrentSince Aug 1, 2021 Accepting new patients
Vision Innovation Centers of Pennsylvania LLC Optometrist CurrentSince Aug 1, 2021 Accepting new patients
Vision Innovation Centers of Pennsylvania LLC Optometrist Past Accepting new patients

Locations

2661 Riva Rd
Ste 1030
Annapolis, MD 21401

703 Rutter Ave
Kingston, PA 18704
Phone (570) 288-7405

1582 Main St
Peckville, PA 18452
Phone (570) 278-2279

200 Mifflin Ave
Scranton, PA 18503
Phone (570) 342-3145

170 Boston Ave
West Pittston, PA 18643
Phone (570) 602-1010

Interoperability endpoints

  • Direct secure messaging: lisa.mongiello@vip.emadirect.md

Organizations & group practices 3

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1548273600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2661 RIVA RD STE 1030",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017131",
            "telephone_number": "667-354-5528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MIFFLIN AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185031982",
            "telephone_number": "570-342-3145",
            "fax_number": "570-344-1309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONGIELLO",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "15788",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001504280",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "506554",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "M0774785",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410032103",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "081377",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.