Individual provider Active NPI

Rebecca Verna, O.D.

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1821290792
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000070 Issued in PA
Practice address
3300 Grant Ave Ste 21
Philadelphia, PA 19114-2632
Phone
(215) 335-9090
Fax
(215) 333-5225
NPI assigned
Jun 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000070 PA Primary

Addresses

Primary practice location

3300 Grant Ave Ste 21
Philadelphia, PA 19114-2632

Mailing address

3300 Grant Ave Ste 21
Philadelphia, PA 19114-2632
Phone (215) 335-9090

Other identifiers 3

IdentifierTypeStateIssuer
3533797000OtherPAKEYSTONE HEALTH PLAN EAST
3533797000OtherPAPERSONAL CHOICE BLUE SHIELD
102306414MedicaidPA

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
I20081107000591 PA Practitioner - Optometry 7315006186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3300 Grant Ave
Suite 21
Philadelphia, PA 19114-2632
Phone (215) 335-9090

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG000070PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Optometry, Inc. Optometrist CurrentSince Jul 1, 2015 Accepting new patients
Philadelphia Vision Center of Erie Ave Inc Optometrist Past Accepting new patients
James R. Filippo, OD Optometrist Past Accepting new patients

Locations

2614 Rhawn St
Philadelphia, PA 19152
Phone (215) 335-9090

3300 Grant Ave
Ste 21
Philadelphia, PA 19114
Phone (215) 335-9090

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": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1821290792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 GRANT AVE STE 21",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191142632",
            "telephone_number": "215-335-9090",
            "fax_number": "215-333-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 GRANT AVE STE 21",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191142632",
            "telephone_number": "215-335-9090",
            "fax_number": "215-333-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERNA",
        "first_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN EAST",
            "identifier": "3533797000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CHOICE BLUE SHIELD",
            "identifier": "3533797000",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102306414",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.