Individual provider Active NPI

Kaitlyn Brosie, OD

  • Optometrist
  • Dallastown, PA
National Provider Identifier
1710588652
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003742 Issued in PA
Practice address
2791 S Queen St
Dallastown, PA 17313-9540
Phone
(717) 741-4788
NPI assigned
Nov 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003742 PA Primary

Addresses

Primary practice location

2791 S Queen St
Dallastown, PA 17313-9540

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other practice location 1

2155 White St
York, PA 17404-4900
Phone (717) 848-4654

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
I20201124000573 PA Practitioner - Optometry 7911318928 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Andrews Eye CorporationGroup PAC ID 8729346788, 5 clinicians
Myeyedr Optometry of Pennsylvania LLCGroup PAC ID 3971884883, 118 clinicians

Practice addresses (Care Compare)

117 W Main St
Optometric Associates
New Holland, PA 17557-1298
Phone (717) 354-2020

125 S Antrim Way
Greencastle, PA 17225-1521
Phone (717) 597-4780

1555 Highlands Dr
Suite 180
Lititz, PA 17543-2800
Phone (717) 625-4600

180 Good Dr
Suite 2
Lancaster, PA 17603-4359
Phone (717) 397-2020

2155 White St
York, PA 17404-4900
Phone (717) 848-4654

2791 S Queen St
Dallastown, PA 17313-9540
Phone (717) 741-4788

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
OEG003742PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist CurrentSince Nov 30, 2020 Accepting new patients
Andrews Eye Corporation Optometrist CurrentSince Apr 19, 2025 Accepting new patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist CurrentSince Nov 30, 2020 Accepting new patients
Wolfram H Andrews Optometrist PastSince Apr 19, 2025 Accepting new patients

Locations

2791 S Queen St
Dallastown, PA 17313
Phone (717) 741-4788

125 S Antrim Way
Greencastle, PA 17225
Phone (717) 597-4780

1555 Highlands Dr
Ste 180
Lititz, PA 17543
Phone (717) 625-4600

117 W Main St
New Holland, PA 17557
Phone (717) 354-2020

2155 White St
York, PA 17404
Phone (717) 848-4654

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1710588652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2791 S QUEEN ST",
            "city": "DALLASTOWN",
            "state": "PA",
            "postal_code": "173139540",
            "telephone_number": "717-741-4788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2155 White St",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174044900",
            "country_code": "US",
            "telephone_number": "717-848-4654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROSIE",
        "first_name": "KAITLYN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-06",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallastown, PA

Sources for this page

Verify at the official NPI Registry.