Everett Eye Care Center, LLC
Organization Active NPI Optometrist · Everett, PA
NPI 1902379936 · NPPES record last updated Mar 6, 2025
Key facts
- NPI
- 1902379936
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- EVERETT EYE CARE CENTER, LLC
- Practice address
- 33 E Main St
Everett, PA 15537-1257 - Phone
- (814) 652-6221
- Fax
- (814) 652-9143
- NPI assigned
- Jan 2, 2019
- Organization subpart
- No
Authorized official
- Name
- Dr. Jessica Suzanne Stone, OD
- Title
- Owner/Optometrist
- Phone
- (814) 652-6221
Practitioners 3
-
Alex J Corle, O.D.
-
Mark Steven Rakoczy, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190205000061 | PA | Part B Supplier - Clinic/Group Practice | 5395083083 |
Receives reassigned benefits from 2 practitioners Practice locations: Everett, PA |
National Provider Directory
Locations
33 E Main St
Everett, PA 15537
Phone (814) 652-5633
141 E Main St
Everett, PA 15537
Phone (814) 283-5535
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
33 E Main St
Everett, PA 15537-1257
Mailing address
33 E Main St
Everett, PA 15537-1257
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103377027001 | 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 Mar 6, 2025. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.