Organization Active NPI

Mastrian Eyecare, LLC

  • Optometrist
  • Hermitage, PA
National Provider Identifier
1811299191
Registry record updated May 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MASTRIAN EYECARE, LLC
Practice address
490 N Kerrwood Dr
Suite 203
Hermitage, PA 16148-5202
Phone
(724) 342-2733
Fax
(724) 342-6652
NPI assigned
Nov 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2011

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

Authorized official

Name
Louis W. Mastrian, O.D.NPI 1255314043
Title
Owner
Phone
(724) 342-2733

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

490 N Kerrwood Dr
Suite 203
Hermitage, PA 16148-5202

Mailing address

490 N Kerrwood Dr
Suite 203
Hermitage, PA 16148-5202
Phone (724) 342-2733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110407000376 PA Part B Supplier - Clinic/Group Practice 6204017114 Receives reassigned benefits from 3 practitioners
Practice locations: Hermitage, PA

National Provider Directory

National Provider Directory

Locations

490 N Kerrwood Dr
Ste 203
Sharon, PA 16148
Phone (724) 342-2733

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304640000000",
    "number": "1811299191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 N KERRWOOD DR",
            "address_2": "SUITE 203",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "161485202",
            "telephone_number": "724-342-2733",
            "fax_number": "724-342-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 N KERRWOOD DR",
            "address_2": "SUITE 203",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "161485202",
            "telephone_number": "724-342-2733",
            "fax_number": "724-342-6652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASTRIAN EYECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-19",
        "last_updated": "2011-05-06",
        "status": "A",
        "authorized_official_last_name": "MASTRIAN",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-342-2733",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermitage, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.