Active NPI
Marc M Pensak, OD
- Corneal and Contact Management Optometrist
- Scranton, PA
National Provider Identifier
1780725994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Corneal and Contact Management Optometrist
- License
- OE006491P PA
- Practice address
- 1743 N Keyser Ave
Scranton, PA 18508-1261 - Phone
- (570) 961-1400
- Fax
- (570) 961-0744
- NPI assigned
- Feb 9, 2007
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | OE006491P PA | PA | Primary |
Addresses
Primary practice location
1743 N Keyser Ave
Scranton, PA 18508-1261
Mailing address
1743 N Keyser Ave
Scranton, PA 18508-1261
Phone (570) 961-1400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OE006491P PA | PA | MD | Corneal and Contact Management Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1780725994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1743 N KEYSER AVE",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185081261",
"telephone_number": "570-961-1400",
"fax_number": "570-961-0744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1743 N KEYSER AVE",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185081261",
"telephone_number": "570-961-1400",
"fax_number": "570-961-0744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENSAK",
"first_name": "MARC",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-09",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "PA",
"license": "OE006491P PA",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scranton, PA
- Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy #06790)
- Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy #01593)
- Pennsylvania LTC Inc (Linwood Nursing and Rehabilitation Center)
- Pennsylvania Physician Services, LLC
- Pennsylvania Physician Services, LLC
- John Andre Pepen
- Tara Ann Peregrim, M.S. CCC-SLP
- Carol Ann C Perfilio Pamelia, DC
- Joyce A Perih, DDS, MS
- Katie Lynn Pernot-Moyer, CRNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.