Individual provider Active NPI

Diane G Fries-Balog, O.D.

  • Optometrist
  • Pottstown, PA
National Provider Identifier
1730103946
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001588 Issued in PA
Practice address
531 N Charlotte St
Pottstown, PA 19464-4602
Phone
(610) 323-0450
Fax
(610) 323-6369
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG001588 PA Primary
Optometrist 152W00000X 27OA00519300 NJ

Addresses

Primary practice location

531 N Charlotte St
Pottstown, PA 19464-4602

Mailing address

531 N Charlotte St
Pottstown, PA 19464-4602
Phone (610) 323-0450

Other identifiers 7

IdentifierTypeStateIssuer
NJ1588OtherPAEYEMED
766110OtherPAHIGHMARK BC/BS
PA77433-1OtherPAVISION BENEFITS OF AMERICA (VBA)
0018193600003MedicaidPA
4390338OtherPAAETNA PPO
1105628OtherPAAETNA HMO
55470OtherPADAVISVISION

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
I20060501000129 PA Practitioner - Optometry 3375553779 Practice locations: Pottstown, PA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

531 N Charlotte St
Pottstown, PA 19464-4602
Phone (610) 323-0450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00519300NJMDOptometrist
OEG001588PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Royer Optical, LLC Past 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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1730103946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 N CHARLOTTE ST",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194644602",
            "telephone_number": "610-323-0450",
            "fax_number": "610-323-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 N CHARLOTTE ST",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194644602",
            "telephone_number": "610-323-0450",
            "fax_number": "610-323-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIES-BALOG",
        "first_name": "DIANE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001588",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00519300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "NJ1588",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BC/BS",
            "identifier": "766110",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISION BENEFITS OF AMERICA (VBA)",
            "identifier": "PA77433-1",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018193600003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4390338",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "1105628",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVISVISION",
            "identifier": "55470",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pottstown, PA

Sources for this page

Verify at the official NPI Registry.