Individual provider Active NPI

Leslie Suzanne Gibson, OD

  • Optometrist
  • Greensburg, PA
National Provider Identifier
1609352368
Registry record updated Jul 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003423 Issued in PA
Practice address
1225 S Main St Ste 307
Greensburg, PA 15601-5370
Phone
(724) 838-7361
NPI assigned
Jul 16, 2018
Last updated
Jul 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003423 PA Primary

Addresses

Primary practice location

1225 S Main St Ste 307
Greensburg, PA 15601-5370

Mailing address

218 E Loyalhanna St
Ligonier, PA 15658-1316
Phone (724) 858-9121

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
I20180827002460 PA Practitioner - Optometry 2466701362 Reassigns benefits to 2 organizations
Practice locations: Latrobe, PA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Youngwood Eye Care IncGroup PAC ID 1052674892, 3 clinicians
2020 Vision Care LLCGroup PAC ID 6709135130, 4 clinicians

Practice addresses (Care Compare)

310 N 3Rd St
Youngwood, PA 15697-1614

4203 Murray Ave
Pittsburgh, PA 15217-2975
Phone (412) 421-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
2020 Vision Care LLC Optometrist CurrentSince May 1, 2020 Accepting new patients
Youngwood Eye Care, Inc Optometrist CurrentSince Jan 16, 2025 Accepting new patients
Evan J Merenstein & Barry a Merenstein PastSince May 1, 2020 Accepting new patients

Locations

4203 Murray Ave
Pittsburgh, PA 15217
Phone (412) 421-2020

531 Greenfield Ave
Pittsburgh, PA 15207

310 N 3rd St
#1
Youngwood, PA 15697
Phone (724) 925-2341

Organizations & group practices 3

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": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531699200000",
    "number": "1609352368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 E LOYALHANNA ST",
            "city": "LIGONIER",
            "state": "PA",
            "postal_code": "156581316",
            "telephone_number": "724-858-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 S MAIN ST STE 307",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156015370",
            "telephone_number": "724-838-7361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "LESLIE",
        "middle_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-16",
        "last_updated": "2018-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensburg, PA

Sources for this page

Verify at the official NPI Registry.