Individual provider Active NPI

Christin Noel Demoss, OD

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1902336043
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003266 Issued in PA
Practice address
1200 W Godfrey Ave
Philadelphia, PA 19141-3323
Phone
(215) 276-6000
NPI assigned
Jun 12, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003266 PA Primary

Addresses

Primary practice location

1200 W Godfrey Ave
Philadelphia, PA 19141-3323

Mailing address

1200 W Godfrey Avenue
Administration
Philadelphia, PA 19141-3323
Phone (215) 276-6070

Other practice location 1

3300 Henry Ave
Philadelphia, PA 19129-1121
Phone (215) 276-6000

Other practice location 2

7630 Germantown Ave
Philadelphia, PA 19118-3529
Phone (215) 276-6000

Other identifiers 1

IdentifierTypeStateIssuer
OEG003266OtherPALICENSE

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
I20170825000336 PA Practitioner - Optometry 7416229455 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Drexel UniversityGroup PAC ID 5496664740, 80 clinicians

Practice addresses (Care Compare)

1200 W Godfrey Ave
Philadelphia, PA 19141-3323
Phone (215) 276-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Drexel University CurrentSince Dec 23, 2024 Accepting new patients
Salus University Hearing Vision Balance Clinic Optometrist CurrentSince Jul 1, 2017 Accepting new patients
Drexel University Optometrist CurrentSince Jul 1, 2017 Accepting new patients
Drexel University Current Accepting new patients
Pennsylvania College of Optometry Optometrist Past Accepting new patients

Locations

1200 W Godfrey Ave
Philadelphia, PA 19141
Phone (215) 276-6000

1427 Vine St
Fl 2
Philadelphia, PA 19102
Phone (215) 762-2530

1427 Vine St
Fl 8
Philadelphia, PA 19102
Phone (215) 762-6660

7630 Germantown Ave
Philadelphia, PA 19118
Phone (215) 276-6000

7630 Germantown Ave
Ste 4
Philadelphia, PA 19118
Phone (215) 276-6000

Interoperability endpoints

  • Direct secure messaging: christin.demoss.p1@direct.salusuhealth.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1902336043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W GODFREY AVENUE",
            "address_2": "ADMINISTRATION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413323",
            "telephone_number": "215-276-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W GODFREY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413323",
            "telephone_number": "215-276-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Henry Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191291121",
            "country_code": "US",
            "telephone_number": "215-276-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7630 Germantown Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191183529",
            "country_code": "US",
            "telephone_number": "215-276-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMOSS",
        "first_name": "CHRISTIN",
        "middle_name": "NOEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "OEG003266",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.