Individual provider Active NPI

Anthony A Krasnicke, O.D.

  • Optometrist
  • Bethlehem, PA
National Provider Identifier
1770503088
Registry record updated Nov 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000045 Issued in PA
Practice address
547 Main St
Bethlehem, PA 18018-5810
Phone
(610) 866-5815
Fax
(610) 866-2450
NPI assigned
Jul 20, 2006
Last updated
Nov 20, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000045 PA Primary
Corneal and Contact Management Optometrist 152WC0802X OEG000045 PA

Addresses

Primary practice location

547 Main St
Bethlehem, PA 18018-5810

Mailing address

547 Main St
Bethlehem, PA 18018-5810
Phone (610) 866-5815

Other identifiers 4

IdentifierTypeStateIssuer
0051223000OtherPAINDEPENDENCE BLUE CROSS
50009423OtherPACAPITAL BLUE CROSS/CAIC
KR287711OtherPAHIGHMARK BLUE SHIELD
5324073OtherAETNA

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
I20100504000762 PA Practitioner - Optometry 9436287968 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG000045PAMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bethlehem Eye Care Associates, P. C. Optometrist CurrentSince Dec 4, 1978 Accepting new patients
Bethlehem Eye Care Associates, P. C. Past Accepting new patients

Locations

547 Main St
Bethlehem, PA 18018
Phone (610) 866-5815

Organizations & group practices 2

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195516800000",
    "number": "1770503088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 MAIN ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180185810",
            "telephone_number": "610-866-5815",
            "fax_number": "610-866-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "547 MAIN ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180185810",
            "telephone_number": "610-866-5815",
            "fax_number": "610-866-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASNICKE",
        "first_name": "ANTHONY",
        "middle_name": "A",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000045",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "PA",
            "license": "OEG000045",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "0051223000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS/CAIC",
            "identifier": "50009423",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "KR287711",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5324073",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.