Individual provider Active NPI

Mark B Cohen, O.D.

  • Optometrist
  • Harrisburg, PA
National Provider Identifier
1649266602
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG 41 Issued in PA
Practice address
4854 Londonderry Rd
Harrisburg, PA 17109-5207
Phone
(717) 657-3682
NPI assigned
Sep 26, 2005
Reactivated
Apr 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG 41 PA Primary

Addresses

Primary practice location

4854 Londonderry Rd
Harrisburg, PA 17109-5207

Mailing address

4034 Silver Charm CT
Harrisburg, PA 17112-1480
Phone (717) 319-2089

Other practice location 1

1130 S 19th St
Harrisburg, PA 17104-2912
Phone (717) 238-2531

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
I20100924001129 PA Practitioner - Optometry 7911023130 Reassigns benefits to 2 organizations
Practice locations: Harrisburg, PA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Vision Center IncGroup PAC ID 7719959063, 4 clinicians

Practice addresses (Care Compare)

4854 Londonderry Rd
Harrisburg, PA 17109-5207
Phone (717) 657-3682

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG 41PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Resources of Central Pennsylvania CurrentSince Sep 1, 2022 Accepting new patients
Capital Vision Center Inc Optometrist CurrentSince Feb 15, 2024 Accepting new patients

Locations

4854 Londonderry Rd
Harrisburg, PA 17109
Phone (717) 652-7774

1130 S 19th St
Harrisburg, PA 17104
Phone (717) 238-2531

Organizations & group practices 2

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": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1649266602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4034 SILVER CHARM CT",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171121480",
            "telephone_number": "717-319-2089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4854 LONDONDERRY RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171095207",
            "telephone_number": "717-657-3682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1130 S 19th St",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171042912",
            "country_code": "US",
            "telephone_number": "717-238-2531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COHEN",
        "first_name": "MARK",
        "middle_name": "B",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "deactivation_date": "2006-03-24",
        "reactivation_date": "2006-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG 41",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.