NPIMap

Organization Active NPI

Dr Sandra M Krokos & Thomas P Kislan PC

Doing business as Hazleton Eye Specialists

  • Optometrist
  • Hazle Township, PA
National Provider Identifier
1699947085
Registry record updated Jul 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OE-000090 Issued in PA
Legal business name
DR SANDRA M KROKOS & THOMAS P KISLAN PC
Doing business as
Hazleton Eye Specialists
Practice address
281 Airport Road
Hazle Township, PA 18202
Phone
(570) 453-2020
Fax
(570) 453-1020
NPI assigned
Mar 26, 2008
Last updated
Jul 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2010

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

Authorized official

Name
Dr. Thomas P Kislan, O.D.NPI 1255319646
Title
Medical Director
Phone
(570) 453-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OE-000090 PA Primary

Addresses

Primary practice location

281 Airport Road
Hazle Township, PA 18202

Mailing address

281 Airport Rd
Hazle Township, PA 18202-3320
Phone (570) 453-2020

Other names 1

  • Hazleton Eye Specialists Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040426000070 PA Part B Supplier - Clinic/Group Practice 6406842202 Receives reassigned benefits from 13 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bangor, PA; Hazletownship, PA; Nanticoke, PA; Pottsville, PA; Tannersville, PA
O20100930071174 PA DME Supplier - Physician - Optometrist 6406842202 Practice locations: Hazle Township, PA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2055580Hazleton Eye Specialists281 Airport Road, Hazleton, PA 18202Certificate of waiverMar 13, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Dr Sandra M Krokos & Thomas P Kisla281 Airport Rd, Hazle Township, PA 18202-3320(570) 453-2020 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Oct 1, 2001

National Provider Directory

National Provider Directory
Tax ID family
Dr Sandra M Krokos Thomas4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280361600000",
    "number": "1699947085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 AIRPORT RD",
            "city": "HAZLE TOWNSHIP",
            "state": "PA",
            "postal_code": "182023320",
            "telephone_number": "570-453-2020",
            "fax_number": "570-453-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 AIRPORT ROAD",
            "city": "HAZLE TOWNSHIP",
            "state": "PA",
            "postal_code": "18202",
            "telephone_number": "570-453-2020",
            "fax_number": "570-453-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR SANDRA M KROKOS & THOMAS P KISLAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2010-07-29",
        "status": "A",
        "authorized_official_last_name": "KISLAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "570-453-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OE-000090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hazleton Eye Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hazle Township, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.