Active NPI
Richard Eugene Margerum, OD
- Optometrist
- Moscow, PA
National Provider Identifier
1891782215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OEG000593
- Practice address
- 326 N Main St
Moscow, PA 18444-9155 - Phone
- (570) 842-2400
- NPI assigned
- Sep 30, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OEG000593 | PA | Primary |
Addresses
Primary practice location
326 N Main St
Moscow, PA 18444-9155
Mailing address
326 N Main St
PO Box 747
Moscow, PA 18444-9155
Phone (570) 842-2400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA288378 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283817600000",
"number": "1891782215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "326 N MAIN ST",
"address_2": "PO BOX 747",
"city": "MOSCOW",
"state": "PA",
"postal_code": "184449155",
"telephone_number": "570-842-2400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "326 N MAIN ST",
"city": "MOSCOW",
"state": "PA",
"postal_code": "184449155",
"telephone_number": "570-842-2400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARGERUM",
"first_name": "RICHARD",
"middle_name": "EUGENE",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-30",
"last_updated": "2010-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OEG000593",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MA288378",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Moscow, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.