Organization Active NPI

Restore Eye Care, P.C.

  • Optometrist
  • State College, PA
National Provider Identifier
1821078569
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000589 Issued in PA
Legal business name
RESTORE EYE CARE, P.C.
Practice address
100 Oakwood Ave
Oakwood Centre Ste 300
State College, PA 16803
Phone
(814) 272-0262
Fax
(814) 272-1501
NPI assigned
Jan 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Authorized official

Name
Dr. Tracy C Sepich, O.D.NPI 1407826969
Title
President
Phone
(814) 272-0262

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 OEG000589 PA Primary

Addresses

Primary practice location

100 Oakwood Ave
Oakwood Centre Ste 300
State College, PA 16803

Mailing address

100 Oakwood Ave
Oakwood Centre Ste 300
State College, PA 16803
Phone (814) 272-0262

Other names 1

  • Sepich Eye Care, P.C. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060103000399 PA Part B Supplier - Clinic/Group Practice 7719909829 Receives reassigned benefits from 3 practitioners
Practice locations: Port Matilda, PA
O20100930008993 PA DME Supplier - Physician - Optometrist 7719909829 Practice locations: Port Matilda, PA

National Provider Directory

National Provider Directory

Locations

650 Grays Woods Blvd
Ste 120
Port Matilda, PA 16870
Phone (814) 272-0262

100 Oakwood Ave
Ste 300
State College, PA 16803
Phone (814) 272-0262

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": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465344000000",
    "number": "1821078569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 OAKWOOD AVE",
            "address_2": "OAKWOOD CENTRE STE 300",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "16803",
            "telephone_number": "814-272-0262",
            "fax_number": "814-272-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 OAKWOOD AVE",
            "address_2": "OAKWOOD CENTRE STE 300",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "16803",
            "telephone_number": "814-272-0262",
            "fax_number": "814-272-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE EYE CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2016-06-08",
        "status": "A",
        "authorized_official_last_name": "SEPICH",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-272-0262",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sepich Eye Care, P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; 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.