Mary L Petrunyak, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG455 Issued in PA

Practice address

1008 Maple Ave
Northern Cambria, PA 15714-1353

Phone

(814) 948-8600

Fax

(814) 948-8790

NPI assigned

Jul 26, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205107200000",
    "number": "1780684472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 MAPLE AVE",
            "city": "NORTHERN CAMBRIA",
            "state": "PA",
            "postal_code": "157141353",
            "telephone_number": "814-948-8600",
            "fax_number": "814-948-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 MAPLE AVE",
            "city": "NORTHERN CAMBRIA",
            "state": "PA",
            "postal_code": "157141353",
            "telephone_number": "814-948-8600",
            "fax_number": "814-948-8790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUNYAK",
        "first_name": "MARY",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2008-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "PE959756",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016841060003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA HEALTH & WELFAREFUND",
            "identifier": "1535716",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northern Cambria School District
• Alissa Olsavsky, DPT
• Mandi Paronish, BSN, RN, CPN
• William J Paronish, MD
• Penn Neuromuscular Diagnostics LLC
• Christina Rakaczky
• Resta Home Health, LLC
• Rite Aid of Pennsylvania LLC
• Ernest J Sekerak, MPT, CSCS
• Robert F Slavik, RPH

• Optometrist in Northern Cambria, PA
• Providers in Northern Cambria, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; 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.