Individual provider Active NPI

Kenneth W Savitski, O.D.

  • Optometrist
  • Peckville, PA
National Provider Identifier
1568467629
Registry record updated Jul 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000836 Issued in PA
Practice address
1005 Main St
Peckville, PA 18452-2166
Phone
(570) 489-8989
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000836 PA Primary

Addresses

Primary practice location

1005 Main St
Peckville, PA 18452-2166

Mailing address

1005 Main St
Peckville, PA 18452-2166
Phone (570) 489-8989

Other identifiers 1

IdentifierTypeStateIssuer
0011166190002MedicaidPA

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
I20111111000310 PA Practitioner - Optometry 2961520200 Practice locations: Peckville, PA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1005 Main St
Peckville, PA 18452-2166
Phone (570) 489-8989

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG000836PAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278374400000",
    "number": "1568467629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 MAIN ST",
            "city": "PECKVILLE",
            "state": "PA",
            "postal_code": "184522166",
            "telephone_number": "570-489-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 MAIN ST",
            "city": "PECKVILLE",
            "state": "PA",
            "postal_code": "184522166",
            "telephone_number": "570-489-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAVITSKI",
        "first_name": "KENNETH",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2010-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011166190002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peckville, PA

Sources for this page

Verify at the official NPI Registry.