Individual provider Active NPI

Thomas M Gulibon Jr., O.D.

  • Optometrist
  • Easton, PA
National Provider Identifier
1790788149
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000234 Issued in PA
Practice address
4753 Freemansburg Ave
Easton, PA 18045-5529
Phone
(610) 866-1000
Fax
(610) 866-9583
NPI assigned
May 31, 2005
Last updated
Dec 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000234 PA Primary

Addresses

Primary practice location

4753 Freemansburg Ave
Easton, PA 18045-5529

Mailing address

4753 Freemansburg Ave
Easton, PA 18045-5529
Phone (610) 866-1000

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
I20101026001287 PA Practitioner - Optometry 6608069398 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alpha Optical Bethlehem, LLCGroup PAC ID 2961838032, 4 clinicians

Practice addresses (Care Compare)

4753 Freemansburg Ave
Easton, PA 18045-5529
Phone (610) 866-1000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenixville Eye Care Specialists Optometrist CurrentSince Aug 29, 1996 Accepting new patients
Alpha Optical Bethlehem, LLC Optometrist CurrentSince Dec 1, 2020 Accepting new patients

Locations

4753 Freemansburg Ave
Easton, PA 18045
Phone (610) 866-1000

720 Main St
Phoenixville, PA 19460
Phone (610) 933-3498

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1790788149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4753 FREEMANSBURG AVE",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180455529",
            "telephone_number": "610-866-1000",
            "fax_number": "610-866-9583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4753 FREEMANSBURG AVE",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180455529",
            "telephone_number": "610-866-1000",
            "fax_number": "610-866-9583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULIBON",
        "first_name": "THOMAS",
        "middle_name": "M",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, PA

Sources for this page

Verify at the official NPI Registry.