Individual provider Active NPI

Gerald E Olson, O.D.

  • Optometrist
  • White Oak, PA
National Provider Identifier
1619979549
Registry record updated Jun 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG00748 Issued in PA
Practice address
2001 Lincoln Way Ste 240
White Oak, PA 15131-2419
Phone
(412) 673-1243
Fax
(412) 673-1129
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG00748 PA Primary

Addresses

Primary practice location

2001 Lincoln Way Ste 240
White Oak, PA 15131-2419

Mailing address

506 Athena Dr
Delmont, PA 15626-1005
Phone (724) 468-6869

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090302000276 PA Practitioner - Optometry 3678639598 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG00748PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist CurrentSince Apr 15, 2019 Accepting new patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist CurrentSince Apr 15, 2019 Accepting new patients
Associates in Ophthalmology LTD Past Accepting new patients

Locations

125 S Antrim Way
Greencastle, PA 17225
Phone (717) 597-4780

2001 Lincoln Way
White Oak, PA 15131
Phone (412) 672-7154

2001 Lincoln Way
Ste 240
White Oak, PA 15131
Phone (412) 673-1243

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1619979549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 ATHENA DR",
            "city": "DELMONT",
            "state": "PA",
            "postal_code": "156261005",
            "telephone_number": "724-468-6869",
            "fax_number": "724-468-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 LINCOLN WAY STE 240",
            "city": "WHITE OAK",
            "state": "PA",
            "postal_code": "151312419",
            "telephone_number": "412-673-1243",
            "fax_number": "412-673-1129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "GERALD",
        "middle_name": "E",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG00748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Oak, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.