Leon J. Pendracky, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

632-OD Issued in WV

Practice address

117 Three Springs Dr # 3
Weirton, WV 26062-3827

Phone

(304) 748-2055

Fax

(304) 748-2054

NPI assigned

Aug 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Michael P Kucher

  • Optometrist
  • Weirton, WV
  • NPI 1255478749
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1740395342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 THREE SPRINGS DR # 3",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260623827",
            "telephone_number": "304-748-2055",
            "fax_number": "304-748-2054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 THREE SPRINGS DR # 3",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260623827",
            "telephone_number": "304-748-2055",
            "fax_number": "304-748-2054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDRACKY",
        "first_name": "LEON",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "632-OD",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000825",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0150384000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul G. Stakias
• Sherry Craig Paull
• Sandra Pearce
• William J Pearl, LCSW, LPC
• Judith Peckens, RPH
• Alex Michael Pentino, DDS
• Maria Teresa Petrus, MPT
• Edward Michael Phillips, CRNA
• Lisa Marie Phillips
• Christine Piccirillo, RN

• Optometrist in Weirton, WV
• Providers in Weirton, WV by specialty
• Optometrist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.