Active NPI
Leslie E Odell, OD
- Optometrist
- New Freedom, PA
National Provider Identifier
1922009745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OEG001304
- Practice address
- 781 Far Hills Dr Ste 100
New Freedom, PA 17349-8447 - Phone
- (717) 759-5929
- Fax
- (717) 563-0348
- NPI assigned
- Aug 2, 2005
- Sex
- Female
- 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 | OEG001304 | PA | Primary |
Addresses
Primary practice location
781 Far Hills Dr Ste 100
New Freedom, PA 17349-8447
Mailing address
781 Far Hills Dr Ste 100
New Freedom, PA 17349-8447
Phone (717) 759-5929
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1432309 | Other | PA | BLUE SHIELD |
| 50034412 | Other | PA | CAPITAL BLUE CROSS |
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 |
|---|---|---|---|
| OEG001304 | PA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| James P. Tuttle, OD | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Optometrist
- Manchester, PA
- NPI 1255424545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649203200000",
"number": "1922009745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "781 FAR HILLS DR STE 100",
"city": "NEW FREEDOM",
"state": "PA",
"postal_code": "173498447",
"telephone_number": "717-759-5929",
"fax_number": "717-563-0348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "781 FAR HILLS DR STE 100",
"city": "NEW FREEDOM",
"state": "PA",
"postal_code": "173498447",
"telephone_number": "717-759-5929",
"fax_number": "717-563-0348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODELL",
"first_name": "LESLIE",
"middle_name": "E",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-02",
"last_updated": "2022-04-06",
"certification_date": "2022-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OEG001304",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "1432309",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "50034412",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Freedom, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.