Individual provider Active NPI

Renee Desmond Houser

  • Optometrist
  • Lebanon, PA
National Provider Identifier
1730747536
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003799 Issued in PA
Practice address
758 Cumberland St
Lebanon, PA 17042-5247
Phone
(717) 473-3802
Fax
(717) 641-3074
NPI assigned
Jun 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003799 PA Primary

Addresses

Primary practice location

758 Cumberland St
Lebanon, PA 17042-5247

Mailing address

758 Cumberland St
Lebanon, PA 17042-5247
Phone (717) 473-3802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200625001248 FL Practitioner - Optometry 7012339260 Reassigns benefits to 1 organization
I20211104002171 PA Practitioner - Optometry 7012339260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Corl Eyecare, LLCGroup PAC ID 2365787561, 4 clinicians

Practice addresses (Care Compare)

758 Cumberland St
Lebanon, PA 17042-5247
Phone (717) 473-3802

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy R. Corl OD, PC Optometrist CurrentSince Nov 1, 2021 Accepting new patients
Corl Eyecare, LLC Optometrist CurrentSince Nov 1, 2021 Accepting new patients
Jonathan M Frantz, MD PA CurrentSince Jun 17, 2020 Accepting new patients

Locations

12731 New Brittany Blvd
Fort Myers, FL 33907
Phone (941) 418-0999

9617 Gulf Research Ln
South Fort Myers, FL 33912
Phone (239) 418-0262

758 Cumberland St
Lebanon, PA 17042
Phone (717) 473-3802

2901 Horseshoe Pike
Palmyra, PA 17078
Phone (717) 473-3802

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1730747536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "758 CUMBERLAND ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170425247",
            "telephone_number": "717-473-3802",
            "fax_number": "717-641-3074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "758 CUMBERLAND ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170425247",
            "telephone_number": "717-473-3802",
            "fax_number": "717-641-3074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSER",
        "first_name": "RENEE",
        "middle_name": "DESMOND",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.