Individual provider Active NPI

Robert W. Prazer, OD

  • Optometrist
  • Wexford, PA
National Provider Identifier
1780745786
Registry record updated Feb 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001183 Issued in PA
Practice address
110 Vip Dr
Wexford, PA 15090-6923
Phone
(724) 935-9999
Fax
(724) 935-9974
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG001183 PA Primary

Addresses

Primary practice location

110 Vip Dr
Wexford, PA 15090-6923

Mailing address

110 Vip Drive
Wexford, PA 15090-6923
Phone (724) 935-9999

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
I20090220000332 PA Practitioner - Optometry 1850456153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Pennsylvania Professional IncGroup PAC ID 7719218593, 80 clinicians

Practice addresses (Care Compare)

110 Vip Dr
Suite 301
Wexford, PA 15090-6923
Phone (724) 935-9999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG001183PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Pennsylvania Professional Inc Optometrist CurrentSince Aug 1, 2019 Accepting new patients
Aeg Pennsylvania Professional, Inc Optometrist Past Accepting new patients

Locations

211 E Broadway
Alton, IL 62002
Phone (314) 787-0681

187 Scharberry Ln
Mars, PA 16046
Phone (724) 591-5501

110 Vip Dr
Ste 301
Wexford, PA 15090
Phone (724) 935-9999

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234137600000",
    "number": "1780745786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 VIP DRIVE",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150906923",
            "telephone_number": "724-935-9999",
            "fax_number": "724-935-9974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 VIP DR",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150906923",
            "telephone_number": "724-935-9999",
            "fax_number": "724-935-9974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRAZER",
        "first_name": "ROBERT",
        "middle_name": "W.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2009-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wexford, PA

Sources for this page

Verify at the official NPI Registry.