Individual provider Active NPI

Nestor J. Paronish, O.D.

  • Optometrist
  • Clearfield, PA
National Provider Identifier
1760584445
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OE-008409-T Issued in PA
Practice address
100 Supercenter Dr
Clearfield, PA 16830-6027
Phone
(814) 765-5110
NPI assigned
Sep 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OE-008409-T PA Primary

Addresses

Primary practice location

100 Supercenter Dr
Clearfield, PA 16830-6027

Mailing address

100 Supercenter Dr
Clearfield, PA 16830-6027
Phone (814) 765-5110

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
I20160426000985 PA Practitioner - Optometry 5698074607 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OE-008409-TPAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fatula Family Eye Care PLLC Optometrist CurrentSince Apr 1, 2016 Accepting new patients

Locations

20 Industrial Dr
Dubois, PA 15801
Phone (814) 375-5005

1102 Million Dollar Hwy
Saint Marys, PA 15857
Phone (814) 781-1064

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, 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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760584445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SUPERCENTER DR",
            "city": "CLEARFIELD",
            "state": "PA",
            "postal_code": "168306027",
            "telephone_number": "814-765-5110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SUPERCENTER DR",
            "city": "CLEARFIELD",
            "state": "PA",
            "postal_code": "168306027",
            "telephone_number": "814-765-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARONISH",
        "first_name": "NESTOR",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OE-008409-T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearfield, PA

Sources for this page

Verify at the official NPI Registry.