Active NPI
John P Menzel, OD
- Optometrist
- Wilkes Barre, PA
National Provider Identifier
1700898830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OEG001358
- Practice address
- 141 S Main St
Wilkes Barre, PA 18701 - Phone
- (570) 825-3491
- Fax
- (570) 822-5654
- NPI assigned
- Aug 13, 2006
- Last updated
- Jan 11, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OEG001358 | PA | Primary |
Addresses
Primary practice location
141 S Main St
Wilkes Barre, PA 18701
Mailing address
200 Mifflin Ave
Scranton, PA 18503
Phone (570) 342-3145
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 410034667 | Other | RAILROAD MEDICARE | |
| OEG001358 | Other | LICENSE | |
| ME078262 | Other | HIGH MARK BLUE SHIELD | |
| 072089 | Other | FIRST PRIORITY HEALTH | |
| 18730 | Other | GEISINGER HEALTH PLAN | |
| 506550 | Other | AETNA |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263168000000",
"number": "1700898830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 MIFFLIN AVE",
"city": "SCRANTON",
"state": "PA",
"postal_code": "18503",
"telephone_number": "570-342-3145",
"fax_number": "570-344-1309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 S MAIN ST",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "18701",
"telephone_number": "570-825-3491",
"fax_number": "570-822-5654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENZEL",
"first_name": "JOHN",
"middle_name": "P",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2010-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OEG001358",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "410034667",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "OEG001358",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGH MARK BLUE SHIELD",
"identifier": "ME078262",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST PRIORITY HEALTH",
"identifier": "072089",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEISINGER HEALTH PLAN",
"identifier": "18730",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "506550",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilkes Barre, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.