Active NPI
Samantha Lin Jennings, OD
- Optometrist
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OEG003543
- Practice address
- 1200 W Godfrey Ave
Philadelphia, PA 19141-3323 - Phone
- (215) 276-6000
- Fax
- (215) 276-1329
- NPI assigned
- Jul 5, 2019
- Last updated
- Jul 5, 2019
- Sex
- Female
- 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 | OEG003543 | PA | Primary |
Addresses
Primary practice location
1200 W Godfrey Ave
Philadelphia, PA 19141-3323
Mailing address
1200 W Godfrey Ave
Philadelphia, PA 19141-3323
Phone (215) 276-6000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OEG003543 | Other | PA | LICENSE |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
222 E Main St
Village Optical
Collegeville, PA 19426-2650
Phone (610) 489-4100
2944 Conestoga Rd
Unit D4
Glenmoore, PA 19343-9516
Phone (610) 458-7171
2944 Conestoga Rd Unit
D4
Glenmoore, PA 19343-9516
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Elder Eye Care Group, Inc | Optometrist | Current | Accepting new patients |
| Independence Corporation | Optometrist | Current | Accepting new patients |
| Independence Corporation | Optometrist | Current | Accepting new patients |
Locations
1900 W Front St
Berwick, PA 18603
Phone (570) 759-2325
222 E Main St
Collegeville, PA 19426
Phone (570) 550-0168
2944 Conestoga Rd
Unit D4
Glenmoore, PA 19343
Phone (610) 458-7171
501 Kimberton Rd
Phoenixville, PA 19460
Phone (610) 917-9999
2274 MacArthur Rd
Whitehall, PA 18052
Phone (610) 432-3937
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562284800000",
"number": "1730741273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 W GODFREY AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191413323",
"telephone_number": "215-276-6000",
"fax_number": "215-276-1329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 W GODFREY AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191413323",
"telephone_number": "215-276-6000",
"fax_number": "215-276-1329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENNINGS",
"first_name": "SAMANTHA",
"middle_name": "LIN",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-05",
"last_updated": "2019-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OEG003543",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "OEG003543",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.