Individual provider Active NPI

Louisa C. Gaiter Johnson, O.D.

  • Optometrist
  • Levittown, PA
National Provider Identifier
1649584053
Registry record updated Jul 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG002343 Issued in PA
Practice address
1568 Woodbourne Rd
Levittown, PA 19057-1508
Phone
(215) 943-7800
Fax
(215) 943-6254
NPI assigned
Jul 28, 2010
Last updated
Jul 28, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG002343 PA Primary

Addresses

Primary practice location

1568 Woodbourne Rd
Levittown, PA 19057-1508

Mailing address

1568 Woodbourne Rd
Levittown, PA 19057-1508
Phone (215) 943-7800

Other identifiers 1

IdentifierTypeStateIssuer
OEG002343OtherPAPA OPTOMETRIC LICENSE

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
I20110309000736 PA Practitioner - Optometry 5890977003 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tus Ojos IncGroup PAC ID 2365414679, 4 clinicians

Practice addresses (Care Compare)

412 W Lehigh Ave
Philadelphia, PA 19133-3148
Phone (215) 634-6567

PO Box
Suite 60980
Philadelphia, PA 19133-3148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG002343PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Eye Care Centers, PC CurrentSince Dec 1, 2010 Accepting new patients
Tus Ojos Inc Optometrist CurrentSince Jun 11, 2012 Accepting new patients
Total Eye Care Centers PC Optometrist CurrentSince Dec 1, 2010 Accepting new patients

Locations

1568 Woodbourne Rd
Levittown, PA 19057
Phone (215) 943-7800

100 E Lehigh Ave
Ste 201
Philadelphia, PA 19125
Phone (215) 427-6370

412 W Lehigh Ave
Philadelphia, PA 19133
Phone (215) 425-0124

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": "1280275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280275200000",
    "number": "1649584053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1568 WOODBOURNE RD",
            "city": "LEVITTOWN",
            "state": "PA",
            "postal_code": "190571508",
            "telephone_number": "215-943-7800",
            "fax_number": "215-943-6254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1568 WOODBOURNE RD",
            "city": "LEVITTOWN",
            "state": "PA",
            "postal_code": "190571508",
            "telephone_number": "215-943-7800",
            "fax_number": "215-943-6254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LOUISA",
        "middle_name": "C. GAITER",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-28",
        "last_updated": "2010-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA OPTOMETRIC LICENSE",
            "identifier": "OEG002343",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Levittown, PA

Sources for this page

Verify at the official NPI Registry.