Individual provider Active NPI

Justin Sherman, OD

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1669929501
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003226 Issued in PA
Practice address
1930 S Broad St Unit 9
Philadelphia, PA 19145-2328
Phone
(800) 448-6767
Fax
(215) 339-8103
NPI assigned
Sep 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003226 PA Primary

Addresses

Primary practice location

1930 S Broad St Unit 9
Philadelphia, PA 19145-2328

Mailing address

303 Horsham Rd Ste G
Horsham, PA 19044-2029
Phone (267) 965-2599

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
I20161014000373 PA Practitioner - Optometry 8921396516 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moa Medical Practices PCGroup PAC ID 0941626998, 3 clinicians

Practice addresses (Care Compare)

3475 W Chester Pike
Suite 100 Moa Medical Practices PC Newtown
Newtown Square, PA 19073-4281
Phone (610) 422-7999

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Moa Medical Practices PC Optometrist CurrentSince Feb 1, 2022 Accepting new patients
Philadelphia Eye Associates Optometrist CurrentSince Jul 31, 2017 Accepting new patients
Philadelphia Eye Associates CurrentSince Jul 31, 2017 Accepting new patients

Locations

303 Horsham Rd
Ste G
Horsham, PA 19044
Phone (267) 965-2599

781 Far Hills Dr
Ste 100
New Freedom, PA 17349
Phone (571) 291-9779

3475 West Chester Pike
Ste 100
Newtown Square, PA 19073
Phone (610) 422-7999

1420 Walnut St
Ste 600
Philadelphia, PA 19102
Phone (215) 735-6300

840 Walnut St
Ste 1230
Philadelphia, PA 19107
Phone (215) 440-3160

1930 S Broad St
Unit 9
Philadelphia, PA 19145
Phone (215) 339-8100

1703 S Broad St
Philadelphia, PA 19148
Phone (215) 339-8100

840 Walnut St
Philadelphia, PA 19107
Phone (215) 440-3150

8025 Roosevelt Blvd
Philadelphia, PA 19152
Phone (215) 423-5154

633 W Germantown Pike
Ste 100A
Plymouth Meeting, PA 19462
Phone (610) 275-0660

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1669929501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 HORSHAM RD STE G",
            "city": "HORSHAM",
            "state": "PA",
            "postal_code": "190442029",
            "telephone_number": "267-965-2599",
            "fax_number": "267-965-2598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 S BROAD ST UNIT 9",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191452328",
            "telephone_number": "800-448-6767",
            "fax_number": "215-339-8103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERMAN",
        "first_name": "JUSTIN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-08",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.