Individual provider Active NPI

Elizabeth Ann Luscavage, OD

  • Optometrist
  • Kennett Square, PA
National Provider Identifier
1720977150
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG004262 Issued in PA
Practice address
1008 Wawaset Rd
Kennett Square, PA 19348-1002
Phone
(610) 347-1200
Fax
(610) 347-1201
NPI assigned
Jul 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG004262 PA Primary

Addresses

Primary practice location

1008 Wawaset Rd
Kennett Square, PA 19348-1002

Mailing address

1008 Wawaset Rd
Kennett Square, PA 19348-1002
Phone (610) 347-1200

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
I20250805004441 PA Practitioner - Optometry 8628586070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye to Eye OphthalmologyGroup PAC ID 2567478985, 2 clinicians

Practice addresses (Care Compare)

1008 Wawaset Rd
Kennett Square, PA 19348-1002
Phone (610) 347-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG004262PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye to Eye Ophthalmology CurrentSince Aug 1, 2025 Accepting new patients

Organizations & group practices 1

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": "1751328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1720977150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 WAWASET RD",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193481002",
            "telephone_number": "610-347-1200",
            "fax_number": "610-347-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 WAWASET RD",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193481002",
            "telephone_number": "610-347-1200",
            "fax_number": "610-347-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSCAVAGE",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-01",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG004262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennett Square, PA

Sources for this page

Verify at the official NPI Registry.