Individual provider Active NPI

John D Clouser, OD

  • Optometrist
  • West Chester, PA
National Provider Identifier
1861470189
Registry record updated Mar 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0E5207P Issued in PA
Practice address
929 S High St
West Chester, PA 19382-5466
Phone
(610) 696-1415
Fax
(610) 696-8308
NPI assigned
Jan 6, 2006
Last updated
Mar 17, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0E5207P PA Primary

Addresses

Primary practice location

929 S High St
West Chester, PA 19382-5466

Mailing address

929 S High St
West Chester, PA 19382-5466
Phone (610) 696-1415

Other identifiers 1

IdentifierTypeStateIssuer
580000571OtherPARAILROAD MEDICARE

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
I20110106000427 PA Practitioner - Optometry 5294924205 Reassigns benefits to 1 organization
Practice locations: West Chester, PA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0E5207PPAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Independence Corporation Optometrist CurrentSince May 10, 2019 Accepting new patients
Independence Corporation Optometrist CurrentSince May 10, 2019 Accepting new patients

Locations

1900 W Front St
Berwick, PA 18603
Phone (570) 759-2325

4301 Penn Ave
Ste E
Sinking Spring, PA 19608
Phone (610) 670-2020

4447 5th Street Hwy
Temple, PA 19560
Phone (610) 921-5140

2274 MacArthur Rd
Whitehall, PA 18052
Phone (610) 432-3937

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": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1861470189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 S HIGH ST",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193825466",
            "telephone_number": "610-696-1415",
            "fax_number": "610-696-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 S HIGH ST",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193825466",
            "telephone_number": "610-696-1415",
            "fax_number": "610-696-8308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOUSER",
        "first_name": "JOHN",
        "middle_name": "D",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "0E5207P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "580000571",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, PA

Sources for this page

Verify at the official NPI Registry.