Individual provider Active NPI

Sam Kaplan

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1689989691
Registry record updated Aug 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
111988 Issued in PA
Practice address
3810 Morrell Ave
Philadelphia, PA 19114-1915
Phone
(215) 632-6698
Fax
(215) 281-3717
NPI assigned
Aug 13, 2010
Sex
Male
Sole proprietor
Yes

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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
111988PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Morrell Eye Care, Inc. Optometrist Past Accepting new patients
Morrell Optical Inc Optometrist Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 111988 PA Primary

Addresses

NPPES NPI Registry

Primary practice location

3810 Morrell Ave
Philadelphia, PA 19114-1915

Mailing address

3810 Morrell Ave
Philadelphia, PA 19114-1915
Phone (215) 632-6698

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 13, 2010.

{
    "created_epoch": "1281657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281657600000",
    "number": "1689989691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 MORRELL AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141915",
            "telephone_number": "215-632-6698",
            "fax_number": "215-281-3717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 MORRELL AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141915",
            "telephone_number": "215-632-6698",
            "fax_number": "215-281-3717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPLAN",
        "first_name": "SAM",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-13",
        "last_updated": "2010-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "111988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.