Active NPI
Frederic A. Neistadt, O.D.
- Optometrist
- Allentown, PA
National Provider Identifier
1902891971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OEG000893
- Practice address
- 2200 W Hamilton St
Suite 300
Allentown, PA 18104-6337 - Phone
- (610) 437-0717
- Fax
- (610) 437-3741
- NPI assigned
- Sep 15, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OEG000893 | PA | Primary |
Addresses
Primary practice location
2200 W Hamilton St
Suite 300
Allentown, PA 18104-6337
Mailing address
2200 W Hamilton St
Suite 300
Allentown, PA 18104-6337
Phone (610) 437-0717
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 235326 | Other | PA | UNITED HEALTHCARE |
| 391267 | Other | PA | NVA |
| 2394 | Other | PA | AETNA US HEALTHCARE |
| 52295 | Other | PA | DAVIS VISION |
| 01746001 | Other | PA | CAPITAL BLUE CROSS |
| NE286510 | Other | PA | HIGHMARK BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OEG000893 | PA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360627200000",
"number": "1902891971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 W HAMILTON ST",
"address_2": "SUITE 300",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "181046337",
"telephone_number": "610-437-0717",
"fax_number": "610-437-3741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 W HAMILTON ST",
"address_2": "SUITE 300",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "181046337",
"telephone_number": "610-437-0717",
"fax_number": "610-437-3741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEISTADT",
"first_name": "FREDERIC",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-15",
"last_updated": "2013-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OEG000893",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "235326",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NVA",
"identifier": "391267",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA US HEALTHCARE",
"identifier": "2394",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DAVIS VISION",
"identifier": "52295",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "01746001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "NE286510",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.