Stacey Marie Hannan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG001285 Issued in PA

Practice address

2010 Village Center Dr
Wal-Mart Vision Center
Tarentum, PA 15084-3844

Phone

(724) 274-0276

NPI assigned

Jun 20, 2006

Last updated

Dec 20, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Outlook Optometry LLCGroup PAC ID 3072773779, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Outlook Optometry LLC

  • Optometrist
  • Tarentum, PA
  • NPI 1255606034
  Medicare reassignment Care Compare group Authorized official
• Menelaos Liulias OD

  • Optometrist
  • Tarentum, PA
  • NPI 1316109044
  NPD (past)
• Vista Optometry, LLC

  dba Wise Optical

  • Optometrist
  • Grove City, PA
  • NPI 1609061019
  NPD (past)

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198108800000",
    "number": "1699711747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8131 POST RD",
            "city": "ALLISON PARK",
            "state": "PA",
            "postal_code": "151013334",
            "telephone_number": "724-612-3943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 VILLAGE CENTER DR",
            "address_2": "WAL-MART VISION CENTER",
            "city": "TARENTUM",
            "state": "PA",
            "postal_code": "150843844",
            "telephone_number": "724-274-0276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNAN",
        "first_name": "STACEY",
        "middle_name": "MARIE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2007-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001285",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "PA",
            "license": "OEG001285",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "PA",
            "license": "OEG001285",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BC/BS",
            "identifier": "1594678",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009498450001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elie L Francis, M.D.
• Kenneth Asher Glick, MD
• Shannon Goodheart
• Teresa M Groves, MS, CCC/SLP
• Ruthanne Hackman
• Marc Harrison
• Mary M Hart, RN
• Richard Lawrence Hatcher II
• Charles Hoak, LMT
• Kindelan Huber

• Optometrist in Tarentum, PA
• Providers in Tarentum, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.