NPIMap

Organization Active NPI

Yealy Eye Centerville LLC

  • Optometrist
  • Lancaster, PA
National Provider Identifier
1891443057
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
YEALY EYE CENTERVILLE LLC
Practice address
572B and 576 Centerville Road
Lancaster, PA 17601
Phone
(717) 201-3238
NPI assigned
Mar 16, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Authorized official

Name
Michael A Kernisky
Title
Practice Manager
Phone
(717) 201-3238

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

572B and 576 Centerville Road
Lancaster, PA 17601

Mailing address

244 N Queen St
Lancaster, PA 17603-3512

Other names 1

  • Yealy Eye Care & Dry Eye Center of Lancaster Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221202000021 PA Part B Supplier - Clinic/Group Practice 3375911944 Receives reassigned benefits from 11 practitioners
Practice locations: Lancaster, PA

National Provider Directory

National Provider Directory

Locations

576 Centerville Rd
Lancaster, PA 17601
Phone (717) 201-3238

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1891443057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 N QUEEN ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176033512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "572B AND 576 CENTERVILLE ROAD",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "17601",
            "telephone_number": "717-201-3238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YEALY EYE CENTERVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-16",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "KERNISKY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "717-201-3238"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yealy Eye Care & Dry Eye Center of Lancaster",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lancaster, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.