Individual provider Active NPI

Carlene Ann Siracuse, OPTOMETRIST

  • Optometrist
  • Pittston, PA
National Provider Identifier
1639275696
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001828 Issued in PA
Practice address
1850 S Township Blvd
Ste 6
Pittston, PA 18640
Phone
(570) 651-1641
NPI assigned
Sep 16, 2006
Last updated
May 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG001828 PA Primary

Addresses

Primary practice location

1850 S Township Blvd
Ste 6
Pittston, PA 18640

Mailing address

2661 Riva Rd Ste 1030
Annapolis, MD 21401-7131
Phone (570) 288-7405

Other identifiers 1

IdentifierTypeStateIssuer
1017833590001MedicaidPA

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
I20070117000060 PA Practitioner - Optometry 1557362613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

170 Boston Ave
West Pittston, PA 18643-2724
Phone (570) 602-1010

1850 S TWP Blvd
Pittston, PA 18640-3550
Phone (570) 654-1641

Merit-based Incentive Payment System (MIPS)

Final score
85.08 of 100Reported as group
Quality
85.29
Promoting interoperability
100
Improvement activities
40
Cost
64.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Innovation Centers of Pennsylvania LLC Optometrist CurrentSince Aug 1, 2021 Accepting new patients
Vision Innovation Centers of Pennsylvania LLC Optometrist Current Accepting new patients
Vision Innovation Centers of Pennsylvania LLC CurrentSince Aug 1, 2021 Accepting new patients

Locations

2661 Riva Rd
Ste 1030
Annapolis, MD 21401

703 Rutter Ave
Kingston, PA 18704
Phone (570) 288-7405

200 Mifflin Ave
Scranton, PA 18503
Phone (570) 342-3145

170 Boston Ave
West Pittston, PA 18643
Phone (570) 602-1010

Interoperability endpoints

  • Direct secure messaging: carlene.siracuse@vip.emadirect.md

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1639275696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2661 RIVA RD STE 1030",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017131",
            "telephone_number": "570-288-7405",
            "fax_number": "570-288-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 S TOWNSHIP BLVD",
            "address_2": "STE 6",
            "city": "PITTSTON",
            "state": "PA",
            "postal_code": "18640",
            "telephone_number": "570-651-1641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRACUSE",
        "first_name": "CARLENE",
        "middle_name": "ANN",
        "credential": "OPTOMETRIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1017833590001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittston, PA

Sources for this page

Verify at the official NPI Registry.