Individual provider Active NPI

Gelena Banin, O.D

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1588762231
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001002 Issued in PA
Practice address
11685 Bustleton Ave
Philadelphia, PA 19116-2542
Phone
(917) 449-5033
NPI assigned
Sep 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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 OEG001002 PA Primary

Addresses

Primary practice location

11685 Bustleton Ave
Philadelphia, PA 19116-2542

Mailing address

73 Bruce Dr
Holland, PA 18966-2179
Phone (215) 350-1444

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
I20040908000221 PA Practitioner - Optometry 7315913738 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

Practice addresses (Care Compare)

11685 Bustleton Ave
Philadelphia, PA 19116-2542

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hendrix Vision Center Inc Optometrist CurrentSince Nov 15, 2006 Accepting new patients
Eugene Dyakovetsky MD. PC. Past Accepting new patients

Locations

11685 Bustleton Ave
Philadelphia, PA 19116
Phone (215) 969-3900

11685 Bustleton Ave
Ste 1
Philadelphia, PA 19116
Phone (215) 698-8980

Organizations & group practices 2

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588762231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 BRUCE DR",
            "city": "HOLLAND",
            "state": "PA",
            "postal_code": "189662179",
            "telephone_number": "215-350-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11685 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162542",
            "telephone_number": "917-449-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANIN",
        "first_name": "GELENA",
        "name_prefix": "Miss",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.