Brande Saad Group-Bedford
Organization Active NPI Optometrist · Everett, PA
NPI 1891831079 · NPPES record last updated Jun 10, 2016
Key facts
- NPI
- 1891831079
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- OEG000603 (PA)
- Legal business name
- BRANDE SAAD GROUP-BEDFORD
- Practice address
- 111 Fairview St.
Everett, PA 15537-6337 - Phone
- (814) 623-2020
- Fax
- (814) 623-7816
- NPI assigned
- Jan 29, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Jeffrey C Territo, O.D.
- Title
- Optometrist
- Phone
- (814) 623-2020
Practitioners 4
-
Scott Bauer, OD
-
Whitney Territo, O.D.
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Brande Saad Group-Bedford |
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050418000369 | PA | Part B Supplier - Clinic/Group Practice | 7810935202 |
Receives reassigned benefits from 3 practitioners Practice locations: Everett, PA |
| O20100930033922 | PA | DME Supplier - Physician - Optometrist | 7810935202 | Practice locations: Everett, PA |
National Provider Directory
Locations
127 S Juliana St
Ste 4
Bedford, PA 15522
Phone (814) 623-2020
111 Fairview St
Everett, PA 15537
Phone (814) 623-2020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | OEG000603 | PA | Yes |
Addresses
Primary practice location
111 Fairview St.
Everett, PA 15537-6337
Mailing address
111 Fairview St.
Everett, PA 15537-6337
Phone (814) 623-2020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0011774900006 | Medicaid | PA | |
| 1007346180003 | Medicaid | PA |
Other providers in Everett, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.