Active NPI
Rose Tree Crossroads Eye Care, P.C.
- Optometrist
- Media, PA
National Provider Identifier
1629217054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- ROSE TREE CROSSROADS EYE CARE, P.C.
- Practice address
- 1315 N Providence Rd
Media, PA 19063-1205 - Phone
- (610) 566-6484
- Fax
- (610) 566-6464
- NPI assigned
- Feb 9, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Robert W Guerra, O.D.
- Title
- President
- Phone
- (610) 566-6484
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
1315 N Providence Rd
Media, PA 19063-1205
Mailing address
1315 N Providence Rd
Media, PA 19063-1205
Phone (610) 566-6484
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7776303 | Medicaid | PA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234137600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1252540800000",
"number": "1629217054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1315 N PROVIDENCE RD",
"city": "MEDIA",
"state": "PA",
"postal_code": "190631205",
"telephone_number": "610-566-6484",
"fax_number": "610-566-6464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1315 N PROVIDENCE RD",
"city": "MEDIA",
"state": "PA",
"postal_code": "190631205",
"telephone_number": "610-566-6484",
"fax_number": "610-566-6464"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROSE TREE CROSSROADS EYE CARE, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2009-02-09",
"last_updated": "2009-09-10",
"status": "A",
"authorized_official_last_name": "GUERRA",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "610-566-6484",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7776303",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Media, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.