Individual provider Active NPI

John Thomas Fischer, OD

  • Optometrist
  • Erie, PA
National Provider Identifier
1811419740
Registry record updated Jul 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003305 Issued in PA
Practice address
2203 W 38TH St
Erie, PA 16506-4501
Phone
(814) 938-2020
NPI assigned
Jul 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003305 PA Primary

Addresses

Primary practice location

2203 W 38TH St
Erie, PA 16506-4501

Mailing address

2203 W 38TH St
Erie, PA 16506-4501

Other identifiers 1

IdentifierTypeStateIssuer
OEG003305OtherPAPA OPTOMETRY LICENSE

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
I20170823000013 PA Practitioner - Optometry 5890067045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Ohio Professional PCGroup PAC ID 7618207036, 80 clinicians

Practice addresses (Care Compare)

2240 E 38TH St
Shawnee Optical
Erie, PA 16510-3688
Phone (814) 824-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG003305PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Ohio Professional PC Optometrist CurrentSince May 1, 2020 Accepting new patients
Aeg Ohio Professional PC Optometrist CurrentSince May 1, 2020 Accepting new patients

Locations

128 W 12th St
Ste 200
Erie, PA 16501
Phone (814) 452-2796

2203 W 38th St
Erie, PA 16506
Phone (814) 838-2020

2240 E 38th St
Erie, PA 16510
Phone (814) 824-3937

1200 E Campbell Rd
Ste 108
Richardson, TX 75081
Phone (972) 370-5552

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": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499817600000",
    "number": "1811419740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 W 38TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165064501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 W 38TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165064501",
            "telephone_number": "814-938-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHER",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-12",
        "last_updated": "2017-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA OPTOMETRY LICENSE",
            "identifier": "OEG003305",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.