Individual provider Active NPI

Ross Agagliati, O.D.

  • Optometrist
  • Homestead, PA
National Provider Identifier
1649623992
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003164 Issued in PA
Practice address
360 E Waterfront Dr
Homestead, PA 15120-5004
Phone
(412) 464-2514
Fax
(412) 464-3388
NPI assigned
Jul 21, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003164 PA Primary

Addresses

Primary practice location

360 E Waterfront Dr
Homestead, PA 15120-5004

Mailing address

360 E Waterfront Dr
Homestead, PA 15120-5004
Phone (412) 464-2514

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
I20161019000538 PA Practitioner - Optometry 2567750870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shirley Eye Care LLCGroup PAC ID 7214250729, 3 clinicians

Practice addresses (Care Compare)

241 Rustic Lodge Rd
Indiana, PA 15701-3472
Phone (724) 463-8882

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG003164PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Shirley Eye Care LLC Optometrist CurrentSince Sep 21, 2018 Accepting new patients

Locations

241 Rustic Lodge Rd
Indiana, PA 15701
Phone (724) 463-8882

Organizations & group practices 1

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": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1649623992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 E WATERFRONT DR",
            "city": "HOMESTEAD",
            "state": "PA",
            "postal_code": "151205004",
            "telephone_number": "412-464-2514",
            "fax_number": "412-461-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E WATERFRONT DR",
            "city": "HOMESTEAD",
            "state": "PA",
            "postal_code": "151205004",
            "telephone_number": "412-464-2514",
            "fax_number": "412-464-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGAGLIATI",
        "first_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-21",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, PA

Sources for this page

Verify at the official NPI Registry.