Individual provider Active NPI

Corbin Reppert, OD

  • Optometrist
  • Lititz, PA
National Provider Identifier
1881437002
Registry record updated Jun 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG004171 Issued in PA
Practice address
1555 Highlands Dr
Lititz, PA 17543-2800
Phone
(717) 625-4600
NPI assigned
Jun 15, 2024
Last updated
Jun 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG004171 PA Primary

Addresses

Primary practice location

1555 Highlands Dr
Lititz, PA 17543-2800

Mailing address

2554 Camas LN
East Petersburg, PA 17520-1436

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
I20240723004605 PA Practitioner - Optometry 9032655279 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independence CorporationGroup PAC ID 0749351005, 12 clinicians

Practice addresses (Care Compare)

125 S Antrim Way
Greencastle, PA 17225-1521
Phone (717) 597-4780

1555 Highlands Dr
Suite 180
Lititz, PA 17543-2800
Phone (717) 625-4600

180 Good Dr
Suite 2
Lancaster, PA 17603-4359
Phone (717) 397-2020

905 E Cumberland St
Eyeland Optical
Lebanon, PA 17042-8102
Phone (717) 228-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist CurrentSince Aug 5, 2024 Accepting new patients
Independence Corporation Optometrist CurrentSince Apr 1, 2026 Accepting new patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist CurrentSince Aug 5, 2024 Accepting new patients
Independence Corporation Optometrist CurrentSince Apr 1, 2026 Accepting new patients

Locations

108 N Reading Rd
Ste M
Ephrata, PA 17522
Phone (717) 733-5000

125 S Antrim Way
Greencastle, PA 17225
Phone (717) 597-4780

905 E Cumberland St
Lebanon, PA 17042
Phone (717) 228-2020

2842 S Eagle Rd
Newtown, PA 18940
Phone (215) 579-1155

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

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, 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": "1718409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718409600000",
    "number": "1881437002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2554 CAMAS LN",
            "city": "EAST PETERSBURG",
            "state": "PA",
            "postal_code": "175201436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 HIGHLANDS DR",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175432800",
            "telephone_number": "717-625-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REPPERT",
        "first_name": "CORBIN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-15",
        "last_updated": "2024-06-15",
        "certification_date": "2024-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG004171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lititz, PA

Sources for this page

Verify at the official NPI Registry.