Organization Active NPI

Family Eye Care West L L C

  • Optometrist
  • Greensburg, PA
National Provider Identifier
1821135971
Registry record updated Feb 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000580 Issued in PA
Legal business name
FAMILY EYE CARE WEST L L C
Practice address
2020 Frederickson Place
Greensburg, PA 15601-9688
Phone
(724) 837-1121
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2008

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

Authorized official

Name
Janice B Frederickson, ODNPI 1124023619
Title
Owner Doctor
Phone
(724) 837-1121

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 OEG000580 PA Primary

Addresses

Primary practice location

2020 Frederickson Place
Greensburg, PA 15601-9688

Mailing address

2020 Frederickson Place
Greensburg, PA 15601-9688
Phone (724) 837-1121

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080214000463 PA Part B Supplier - Clinic/Group Practice 2365525284 Receives reassigned benefits from 1 practitioner
Practice locations: Greensburg, PA

National Provider Directory

National Provider Directory

Locations

2020 Frederickson Pl
Greensburg, PA 15601
Phone (724) 837-1121

Practitioners & affiliated clinicians

Practitioners 1

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": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203033600000",
    "number": "1821135971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 FREDERICKSON PLACE",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156019688",
            "telephone_number": "724-837-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 FREDERICKSON PLACE",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156019688",
            "telephone_number": "724-837-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY EYE CARE WEST L L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2008-02-15",
        "status": "A",
        "authorized_official_last_name": "FREDERICKSON",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "724-837-1121",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; 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.