Organization Active NPI

Kissel Village Eye Care

  • Eyewear Supplier
  • Lititz, PA
National Provider Identifier
1770810681
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
OEG001123 Issued in PA
Legal business name
KISSEL VILLAGE EYE CARE
Practice address
1026 Lititz Pike
Lititz, PA 17543-9328
Phone
(717) 625-4989
Fax
(717) 625-7360
NPI assigned
Nov 13, 2009
Last updated
Apr 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

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

Authorized official

Name
Kathryn E Collins, O.D.NPI 1962571521
Title
Optometrist
Phone
(717) 625-4989

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
Eyewear Supplier 332H00000X OEG001123 PA Primary

Addresses

Primary practice location

1026 Lititz Pike
Lititz, PA 17543-9328

Mailing address

1026 Lititz Pike
Lititz, PA 17543-9328
Phone (717) 625-4989

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120209000274 PA Part B Supplier - Clinic/Group Practice 8729245394 Receives reassigned benefits from 2 practitioners
Practice locations: Lititz, PA

National Provider Directory

National Provider Directory

Locations

1026 Lititz Pike
Lititz, PA 17543
Phone (412) 655-3301

1170 Erbs Quarry Rd
Ste 4
Lititz, PA 17543
Phone (717) 625-4989

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1258070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333411200000",
    "number": "1770810681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 LITITZ PIKE",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175439328",
            "telephone_number": "717-625-4989",
            "fax_number": "717-625-7360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 LITITZ PIKE",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175439328",
            "telephone_number": "717-625-4989",
            "fax_number": "717-625-7360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KISSEL VILLAGE EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-13",
        "last_updated": "2012-04-03",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "717-625-4989",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "PA",
            "license": "OEG001123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lititz, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.