Kimberly A. Agostinelli, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG000799 Issued in PA

Practice address

921 Drinker Tpke Ste 15
Covington TWP, PA 18444-7948

Phone

(570) 842-0331

NPI assigned

Jul 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dr. Kimberly A. Suche Former name

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• North Pocono Family Eyecare, LLC

  • Optometrist
  • Covington TWP, PA
  • NPI 1104834266
  Medicare reassignment NPD Authorized official
• Bloom Vision, LLC

  • Optometrist
  • Bloomsburg, PA
  • NPI 1255339065
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409616000000",
    "number": "1902835671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 DRINKER TPKE STE 15",
            "city": "COVINGTON TWP",
            "state": "PA",
            "postal_code": "184447948",
            "telephone_number": "570-842-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 DRINKER TPKE STE 15",
            "city": "COVINGTON TWP",
            "state": "PA",
            "postal_code": "184447948",
            "telephone_number": "570-842-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGOSTINELLI",
        "first_name": "KIMBERLY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2014-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1902835671",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1104834266",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "SUCHE",
            "middle_name": "A.",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Raymond J Felins, MD
• Raymond John Felins
• Anna Haroun Mahdavi
• North Pocono Family Eyecare, LLC
• Tammy Lee Rade, LCSW

• Optometrist in Covington TWP, PA
• Providers in Covington TWP, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.