Individual provider Active NPI

John Scott Pockl, O.D.

  • Optometrist
  • Wheeling, WV
National Provider Identifier
1548347776
Registry record updated Aug 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
904-OD Issued in WV
Practice address
2106 Lumber Ave
Wheeling, WV 26003-5390
Phone
(304) 242-5544
Fax
(304) 242-2560
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 904-OD WV Primary

Addresses

Primary practice location

2106 Lumber Ave
Wheeling, WV 26003-5390

Mailing address

2106 Lumber Ave
Wheeling, WV 26003-5390
Phone (304) 242-5544

Other identifiers 1

IdentifierTypeStateIssuer
0149809000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20101123000364 WV Practitioner - Optometry 7517042872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pockl-Dormas PCGroup PAC ID 5799875415, 4 clinicians

Practice addresses (Care Compare)

2106 Lumber Ave
Wheeling, WV 26003-5390
Phone (304) 242-5544

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
904-ODWVMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pockl-Dormas PC Optometrist CurrentSince Oct 1, 1995 Accepting new patients

Locations

2106 Lumber Ave
Wheeling, WV 26003
Phone (304) 242-5544

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219449600000",
    "number": "1548347776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 LUMBER AVE",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260035390",
            "telephone_number": "304-242-5544",
            "fax_number": "304-242-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 LUMBER AVE",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260035390",
            "telephone_number": "304-242-5544",
            "fax_number": "304-242-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POCKL",
        "first_name": "JOHN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "904-OD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0149809000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

Verify at the official NPI Registry.