Individual provider Active NPI

Allison Marie Benacci, O.D.

  • Optometrist
  • Erie, PA
National Provider Identifier
1609807890
Registry record updated May 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000560 Issued in PA
Practice address
2640 W 38TH St
Erie, PA 16506-4524
Phone
(814) 835-8258
Fax
(814) 838-0104
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000560 PA Primary

Addresses

Primary practice location

2640 W 38TH St
Erie, PA 16506-4524

Mailing address

2640 W 38TH St
Erie, PA 16506-4524
Phone (814) 835-8258

Other identifiers 2

IdentifierTypeStateIssuer
1013650360001MedicaidPA
1013650360002MedicaidPA

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
I20051207000333 PA Practitioner - Optometry 4789604679 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

503 High St
Waterford, PA 16441-9750
Phone (814) 796-1133

Merit-based Incentive Payment System (MIPS)

Final score
80.36 of 100Reported as group
Quality
84.35
Improvement activities
40
Cost
55.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Griffith Eye Center PC Optometrist CurrentSince May 1, 2010 Accepting new patients
Waterford Eye Care, PC Optometrist CurrentSince Dec 28, 2023 Accepting new patients
Precision Vision Center Inc. Optometrist Past Accepting new patients
Ear Nose and Throat Specialists of Northwestern Pennsylvania Past Accepting new patients
Ear Nose and Throat Specialists of Northwestern Pennsylvania Past Accepting new patients
Griffith Eye Center PC Optometrist Past Accepting new patients

Locations

2640 W 38th St
Erie, PA 16506
Phone (814) 835-8258

41 S Lake St
North East, PA 16428
Phone (814) 725-3304

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242777600000",
    "number": "1609807890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 W 38TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165064524",
            "telephone_number": "814-835-8258",
            "fax_number": "814-838-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 W 38TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165064524",
            "telephone_number": "814-835-8258",
            "fax_number": "814-838-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENACCI",
        "first_name": "ALLISON",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2009-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013650360001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013650360002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.