Individual provider Active NPI

Jill Diane Cuthbertson, OD

  • Optometrist
  • Erie, PA
National Provider Identifier
1790843977
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001531 Issued in PA
Practice address
1344 W 38TH St
Erie, PA 16508-2462
Phone
(814) 868-0895
Fax
(814) 868-0896
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG001531 PA Primary

Addresses

Primary practice location

1344 W 38TH St
Erie, PA 16508-2462

Mailing address

1344 W 38TH St
Erie, PA 16508-2462
Phone (814) 868-0895

Other identifiers 3

IdentifierTypeStateIssuer
44402OtherPADAVIS
396826OtherPANVA
0019618410001MedicaidPA

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
I20070924000377 PA Practitioner - Optometry 9032203856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1344 W 38TH St
Erie, PA 16508-2462
Phone (814) 868-0895

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG001531PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jill D Cuthbertson, OD, PC CurrentSince Jul 23, 2014 Accepting new patients
Precision Vision Center Inc. Optometrist Past Accepting new patients
Daniel Hedlund O. D Optometrist PastSince Jul 23, 2014 Accepting new patients

Locations

1344 W 38th St
Erie, PA 16508
Phone (814) 868-0895

Organizations & group practices 3

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407283200000",
    "number": "1790843977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1344 W 38TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082462",
            "telephone_number": "814-868-0895",
            "fax_number": "814-868-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1344 W 38TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082462",
            "telephone_number": "814-868-0895",
            "fax_number": "814-868-0896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUTHBERTSON",
        "first_name": "JILL",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2014-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS",
            "identifier": "44402",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "396826",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019618410001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.