Eric A Pennock, MD

Primary specialty

Pediatric Ophthalmology and Strabismus Specialist PhysicianTaxonomy code 207WX0110X

License

MD436979 Issued in PA

Practice address

124 Graham Park Dr.
Cranberry TWP, PA 16066

Phone

(724) 772-3388

Fax

(724) 772-7021

NPI assigned

Jan 30, 2008

Last updated

Mar 10, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Wright State University Boonshoft School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pediatric Ophthalmology and Strabismus IncGroup PAC ID 4688635204, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pediatric Ophthalmology & Strabismus Inc

  • Ophthalmology Physician
  • Cranberry TWP, PA
  • NPI 1285665356
  Medicare reassignment Care Compare group NPD
• Windber Hospital, Inc.

  dba Windber Medical Center

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)
• Indiana Pediatric Ophthalmology & Adult Strabismus, LLC

  dba Pediatric Ophthalmology and Adult Strabismus, LLC

  • Ophthalmology Physician
  • Indianapolis, IN
  • NPI 1184625436
  NPD (past)

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1760669949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 GRAHAM PARK DR.",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "16066",
            "telephone_number": "724-772-3388",
            "fax_number": "724-772-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 GRAHAM PARK DR.",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "16066",
            "telephone_number": "724-772-3388",
            "fax_number": "724-772-7021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNOCK",
        "first_name": "ERIC",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-30",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD436979",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "01065165A",
            "primary": false
        },
        {
            "code": "207WX0110X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": "PA",
            "license": "MD436979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023382110001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pedeyemd@direct-message.org",
            "affiliation": "N",
            "address_1": "124 Graham Park Dr.",
            "city": "Cranberry Twp",
            "state": "PA",
            "country_code": "US",
            "postal_code": "16066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachael Rose Pauvlinch, PA-C
• John G. Pazin
• Pediatric Ophthalmology & Strabismus Inc
• Ingrid Peeters
• Stephen J Pennell, DC
• Pennsylvania CVS Pharmacy LLC (CVS Pharmacy #16607)
• Jordan Pentes
• Ellen Elyse Petronic, OT
• Alexandra Peworchik, RDN
• Physician Landing Zone, P.C. (Cranberry Internal Medicine Associates)

• Pediatric Ophthalmology and Strabismus Specialist Physician in Cranberry TWP, PA
• Providers in Cranberry TWP, PA by specialty
• Pediatric Ophthalmology and Strabismus Specialist Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.

Verify at the official NPI Registry.