Individual provider Active NPI

John Raymond Seymour, OD

  • Optometrist
  • Ebensburg, PA
National Provider Identifier
1841251741
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0EG000642 Issued in PA
Practice address
414 W High St
Ebensburg, PA 15931-1561
Phone
(814) 472-4240
Fax
(814) 472-4241
NPI assigned
Mar 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0EG000642 PA Primary

Addresses

Primary practice location

414 W High St
Ebensburg, PA 15931-1561

Mailing address

414 W High St
Ebensburg, PA 15931-1561
Phone (814) 472-4240

Other identifiers 1

IdentifierTypeStateIssuer
420181OtherPALMETTO GBA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101008001170 PA Practitioner - Optometry 8224141411 Practice locations: Ebensburg, PA
I20200513003056 SC Practitioner - Optometry 8224141411 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.7 of 100Reported as group
Quality
100
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0EG000642PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster Eye Clinic P.a. CurrentSince Feb 17, 2020 Accepting new patients
360Care LLC Optometrist CurrentSince Feb 3, 2020 Accepting new patients
360Care LLC CurrentSince Feb 3, 2020 Accepting new patients
Onsight Health Care, LLC Past Accepting new patients
Arlow Ophthalmology LLC PastSince Apr 1, 2022 Accepting new patients

Locations

4350 Brownsboro Rd
Ste 200
Louisville, KY 40207
Phone (513) 771-7483

1703 Laurel St
Columbia, SC 29201
Phone 24852821166

1240 Colonial Commons Ct
Lancaster, SC 29720
Phone (803) 285-3333

209 S Wylie St
Lancaster, SC 29720
Phone (803) 285-4333

Interoperability endpoints

  • Direct secure messaging: elcjs09@telc.emadirect.md

Organizations & group practices 5

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": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1841251741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 W HIGH ST",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159311561",
            "telephone_number": "814-472-4240",
            "fax_number": "814-472-4241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 W HIGH ST",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159311561",
            "telephone_number": "814-472-4240",
            "fax_number": "814-472-4241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEYMOUR",
        "first_name": "JOHN",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "0EG000642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "420181",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ebensburg, PA

Sources for this page

Verify at the official NPI Registry.