Individual provider Active NPI

David M Skettini, O.D.

  • Optometrist
  • Lebanon, PA
National Provider Identifier
1720082191
Registry record updated Feb 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000096 Issued in PA
Practice address
875 Norman Dr
Lebanon, PA 17042-7454
Phone
(717) 272-2010
Fax
(717) 272-2937
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000096 PA Primary

Addresses

Primary practice location

875 Norman Dr
Lebanon, PA 17042-7454

Mailing address

1237 Colebrook Rd
Lebanon, PA 17042-6912
Phone (717) 274-8453

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
I20110127000430 PA Practitioner - Optometry 3678752383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
George E. Fava MD PCGroup PAC ID 7517942428, 7 clinicians

Practice addresses (Care Compare)

875 Norman Dr
Lebanon, PA 17042-7454
Phone (717) 275-2010

Merit-based Incentive Payment System (MIPS)

Final score
88.99 of 100Reported as group
Quality
94.96
Promoting interoperability
95
Improvement activities
40
Cost
72.51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG000096PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
George E. Fava MD PC CurrentSince Nov 22, 1994 Accepting new patients
George E Fava MD PC Optometrist CurrentSince Nov 22, 1994 Accepting new patients

Locations

875 Norman Dr
Lebanon, PA 17042
Phone (717) 272-2010

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.

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235001600000",
    "number": "1720082191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 COLEBROOK RD",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170426912",
            "telephone_number": "717-274-8453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 NORMAN DR",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427454",
            "telephone_number": "717-272-2010",
            "fax_number": "717-272-2937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKETTINI",
        "first_name": "DAVID",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2009-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.