Organization Active NPI

Eye Innovations LLC

  • Optometrist
  • Drexel Hill, PA
National Provider Identifier
1770733107
Registry record updated Jul 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYE INNOVATIONS LLC
Practice address
1204 Township Line Rd
1St Floor
Drexel Hill, PA 19026-5034
Phone
(610) 446-3939
Fax
(610) 446-3938
NPI assigned
Sep 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2010

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

Authorized official

Name
Dr. Archima Major, OD, FAAONPI 1265529812
Title
Optometrist
Phone
(610) 446-3939

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1204 Township Line Rd
1St Floor
Drexel Hill, PA 19026-5034

Mailing address

1204 Township Line Rd
1St Floor
Drexel Hill, PA 19026-5034
Phone (610) 446-3939

Other identifiers 1

IdentifierTypeStateIssuer
6314320001OtherPAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091016000066 PA Part B Supplier - Clinic/Group Practice 5991842395 Receives reassigned benefits from 1 practitioner
Practice locations: Drexel Hill, PA; Philadelphia, PA

National Provider Directory

National Provider Directory

Locations

1204 Township Line Rd
Ste 1
Drexel Hill, PA 19026
Phone (610) 446-3939

1325 S 33rd St
Ste 2
Philadelphia, PA 19146
Phone (267) 804-7836

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1222041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278892800000",
    "number": "1770733107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 TOWNSHIP LINE RD",
            "address_2": "1ST FLOOR",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190265034",
            "telephone_number": "610-446-3939",
            "fax_number": "610-446-3938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 TOWNSHIP LINE RD",
            "address_2": "1ST FLOOR",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190265034",
            "telephone_number": "610-446-3939",
            "fax_number": "610-446-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE INNOVATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-22",
        "last_updated": "2010-07-12",
        "status": "A",
        "authorized_official_last_name": "MAJOR",
        "authorized_official_first_name": "ARCHIMA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "610-446-3939",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD, FAAO"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "6314320001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Drexel Hill, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.