Individual provider Active NPI

Amy Kristin Stamm, O.D.

  • Optometrist
  • Seneca, PA
National Provider Identifier
1609990332
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG1355 Issued in PA
Practice address
3216 State Route 257
Duawl Professional Plaza #7
Seneca, PA 16346-0208
Phone
(814) 677-2685
Fax
(814) 677-2686
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 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 OEG1355 PA Primary

Addresses

Primary practice location

3216 State Route 257
Duawl Professional Plaza #7
Seneca, PA 16346-0208

Mailing address

PO Box 208
Seneca, PA 16346-0208
Phone (814) 677-2685

Other identifiers 5

IdentifierTypeStateIssuer
167600OtherPALUXOTTICA PROVIDER ID
397485OtherPANVA
007698243 0003MedicaidPA
ST645829OtherPABLUE CROSS BLUE SHIELD
9176346OtherPAUPMC DORAL

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
I20040816001242 PA Practitioner - Optometry 0547233728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3216 State Route 257
Seneca, PA 16346-2432
Phone (814) 677-2685

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG1355PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Stamm Family Optical P.C. CurrentSince Jul 3, 2008 Accepting new patients

Locations

3216 State Route 257
#7
Seneca, PA 16346
Phone (814) 677-2685

3216 State Route 257
Seneca, PA 16346
Phone (814) 677-2685

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197244800000",
    "number": "1609990332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208",
            "city": "SENECA",
            "state": "PA",
            "postal_code": "163460208",
            "telephone_number": "814-677-2685",
            "fax_number": "814-677-2686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3216 STATE ROUTE 257",
            "address_2": "DUAWL PROFESSIONAL PLAZA #7",
            "city": "SENECA",
            "state": "PA",
            "postal_code": "163460208",
            "telephone_number": "814-677-2685",
            "fax_number": "814-677-2686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAMM",
        "first_name": "AMY",
        "middle_name": "KRISTIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG1355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LUXOTTICA PROVIDER ID",
            "identifier": "167600",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "397485",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007698243 0003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "ST645829",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC DORAL",
            "identifier": "9176346",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, PA

Sources for this page

Verify at the official NPI Registry.