NPIMap

Organization Active NPI

Your Eye Associates LLC

  • Optometrist
  • Harleysville, PA
National Provider Identifier
1639187776
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
YOUR EYE ASSOCIATES LLC
Practice address
426 Main Street
Harleysville, PA 19438-2350
Phone
(215) 256-6735
Fax
(215) 256-9931
NPI assigned
Aug 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Authorized official

Name
Paul Thomas Forrest, ODNPI 1386674042
Title
Owner of Practice
Phone
(215) 256-6735

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X PA Primary

Addresses

Primary practice location

426 Main Street
Harleysville, PA 19438-2350

Mailing address

426 Main Street
Harleysville, PA 19438-2350
Phone (215) 256-6735

Other names 1

  • Harleysville Eye Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210107001693 PA Part B Supplier - Clinic/Group Practice 4688087885 Receives reassigned benefits from 9 practitioners
2 other NPIs on this enrollment
Practice locations: Colmar, PA; Glen Mills, PA; Harleysville, PA; Philadelphia, PA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Chadds Ford Eye Associates3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

426 Main St
Harleysville, PA 19438
Phone (215) 256-6735

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611792000000",
    "number": "1639187776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 MAIN STREET",
            "city": "HARLEYSVILLE",
            "state": "PA",
            "postal_code": "194382350",
            "telephone_number": "215-256-6735",
            "fax_number": "215-256-9931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 MAIN STREET",
            "city": "HARLEYSVILLE",
            "state": "PA",
            "postal_code": "194382350",
            "telephone_number": "215-256-6735",
            "fax_number": "215-256-9931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR EYE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A",
        "authorized_official_last_name": "FORREST",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER OF PRACTICE",
        "authorized_official_telephone_number": "215-256-6735",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harleysville Eye Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harleysville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.