Organization Active NPI

Wichryk Eye Associates, P.C.

  • Optometrist
  • Macungie, PA
National Provider Identifier
1902822331
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000242 Issued in PA
Legal business name
WICHRYK EYE ASSOCIATES, P.C.
Practice address
6451 Village LN
Suite 200
Macungie, PA 18062-8484
Phone
(610) 965-1800
NPI assigned
Jul 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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

Authorized official

Name
Dr. Antoni Michael Wichryk, O.D.NPI 1174611925
Title
President
Phone
(610) 965-1800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OEG000242 PA Primary

Addresses

Primary practice location

6451 Village LN
Suite 200
Macungie, PA 18062-8484

Mailing address

6451 Village LN
Suite 200
Macungie, PA 18062-8484
Phone (610) 965-1800

Other identifiers 2

IdentifierTypeStateIssuer
1017439OtherPAAETNA US HEALTHCARE
267858OtherPABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070419000242 PA Part B Supplier - Clinic/Group Practice 9739284787 Receives reassigned benefits from 3 practitioners
Practice locations: Macungie, PA

National Provider Directory

National Provider Directory

Locations

3261 Route 100
Ste 240
Macungie, PA 18062
Phone (610) 965-1800

Interoperability endpoints

  • Direct secure messaging: drr@wichrykeye.eyefinity-direct.com
  • Direct secure messaging: drtang@wichrykeye.eyefinity-direct.com
  • Direct secure messaging: drw@wichrykeye.eyefinity-direct.com

Practitioners & affiliated clinicians

Practitioners 3

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": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418256000000",
    "number": "1902822331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6451 VILLAGE LN",
            "address_2": "SUITE 200",
            "city": "MACUNGIE",
            "state": "PA",
            "postal_code": "180628484",
            "telephone_number": "610-965-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6451 VILLAGE LN",
            "address_2": "SUITE 200",
            "city": "MACUNGIE",
            "state": "PA",
            "postal_code": "180628484",
            "telephone_number": "610-965-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHRYK EYE ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2014-12-11",
        "status": "A",
        "authorized_official_last_name": "WICHRYK",
        "authorized_official_first_name": "ANTONI",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-965-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "1017439",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "267858",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macungie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; 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.