Individual provider Active NPI

Matthew Paul Graden

  • Optometrist
  • Carlisle, PA
National Provider Identifier
1619653292
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG004022 Issued in PA
Practice address
25 State Ave
Carlisle, PA 17013-4420
Phone
(717) 249-4948
NPI assigned
Jun 27, 2023
Last updated
Jun 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG004022 PA Primary

Addresses

Primary practice location

25 State Ave
Carlisle, PA 17013-4420

Mailing address

164 Stonebrook Dr
Palmyra, PA 17078-4408
Phone (717) 712-6613

Other practice location 1

100 N Walnut St
Mechanicsburg, PA 17055-3364
Phone (717) 766-4757

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
I20230814000562 PA Practitioner - Optometry 5698137339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sans Pareil EyecareGroup PAC ID 7012172869, 17 clinicians

Practice addresses (Care Compare)

100 N Walnut St
Mechanicsburg Eye Associates
Mechanicsburg, PA 17055-3364
Phone (717) 766-4757

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sans Pareil Eyecare Optometrist CurrentSince Jul 1, 2023 Accepting new patients
James P. Tuttle, OD Optometrist Past Accepting new patients
Mechanicsburg Eye Associates LLC Optometrist PastSince Jul 1, 2023 Accepting new patients

Locations

25 State Ave
Carlisle, PA 17013
Phone (717) 220-8980

234 Rosedale Dr
Manchester, PA 17345
Phone (717) 266-5661

100 N Walnut St
Mechanicsburg, PA 17055
Phone (717) 628-3693

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": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1619653292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 STONEBROOK DR",
            "city": "PALMYRA",
            "state": "PA",
            "postal_code": "170784408",
            "telephone_number": "717-712-6613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 STATE AVE",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170134420",
            "telephone_number": "717-249-4948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N Walnut St",
            "address_purpose": "LOCATION",
            "city": "Mechanicsburg",
            "state": "PA",
            "postal_code": "170553364",
            "country_code": "US",
            "telephone_number": "717-766-4757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRADEN",
        "first_name": "MATTHEW",
        "middle_name": "PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-06-27",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG004022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlisle, PA

Sources for this page

Verify at the official NPI Registry.