Individual provider Active NPI

Stephen John Selden, O.D.

  • Optometrist
  • Kittanning, PA
National Provider Identifier
1588741375
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001454 Issued in PA
Practice address
11931 State Route 85
Suite F
Kittanning, PA 16201-3741
Phone
(724) 543-4293
Fax
(724) 543-0228
NPI assigned
Nov 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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 OEG001454 PA Primary

Addresses

Primary practice location

11931 State Route 85
Suite F
Kittanning, PA 16201-3741

Mailing address

11931 State Route 85
Suite F
Kittanning, PA 16201-3741
Phone (724) 543-4293

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
I20080201000162 PA Practitioner - Optometry 8729160502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588741375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11931 STATE ROUTE 85",
            "address_2": "SUITE F",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162013741",
            "telephone_number": "724-543-4293",
            "fax_number": "724-543-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11931 STATE ROUTE 85",
            "address_2": "SUITE F",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162013741",
            "telephone_number": "724-543-4293",
            "fax_number": "724-543-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELDEN",
        "first_name": "STEPHEN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kittanning, PA

Sources for this page

Verify at the official NPI Registry.