John D Clouser, OD

Individual provider Active NPI Optometrist · West Chester, PA

NPI 1861470189 · NPPES record last updated Mar 17, 2016

Key facts

NPI
1861470189
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
0E5207P (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
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
0E5207PPAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Independence Corporation Optometrist Current
since May 10, 2019
Accepting new patients
Independence Corporation Optometrist Current
since 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

Specialties & licenses

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

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

IdentifierTypeStateIssuer
580000571OtherPARAILROAD MEDICARE

Other providers in West Chester, PA

All providers in West Chester, PA · Optometrist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.