Individual provider Active NPI

Joseph Gary Pruzinsky, OD

  • Optometrist
  • Olyphant, PA
National Provider Identifier
1578627402
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OE007359T Issued in PA
Practice address
103 Chaney Drive
Olyphant, PA 18447-1908
Phone
(570) 489-4788
NPI assigned
Dec 22, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OE007359T PA Primary

Addresses

Primary practice location

103 Chaney Drive
Olyphant, PA 18447-1908

Mailing address

103 Chaney Drive
Olyphant, PA 18447-1908
Phone (570) 489-4788

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
I20111214000779 PA Practitioner - Optometry 3779758016 Reassigns benefits to 1 organization
Practice locations: Olyphant, PA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

103 Chaney Dr
Olyphant, PA 18447-1908
Phone (570) 489-4788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel Ganz MD PLLC CurrentSince Sep 9, 2024 Accepting new patients

Locations

500 W Hospital St
Taylor, PA 18517
Phone (570) 483-8450

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578627402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 CHANEY DRIVE",
            "city": "OLYPHANT",
            "state": "PA",
            "postal_code": "184471908",
            "telephone_number": "570-489-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 CHANEY DRIVE",
            "city": "OLYPHANT",
            "state": "PA",
            "postal_code": "184471908",
            "telephone_number": "570-489-4788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUZINSKY",
        "first_name": "JOSEPH GARY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OE007359T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olyphant, PA

Sources for this page

Verify at the official NPI Registry.