Individual provider Active NPI

Gary J. Havranek, O.D.

  • Optometrist
  • Beaver Falls, PA
National Provider Identifier
1922097153
Registry record updated Nov 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000663 Issued in PA
Practice address
1315 6TH Ave
Beaver Falls, PA 15010-4213
Phone
(724) 843-1870
Fax
(724) 843-7275
NPI assigned
Oct 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000663 PA Primary

Addresses

Primary practice location

1315 6TH Ave
Beaver Falls, PA 15010-4213

Mailing address

1315 6TH Ave
Beaver Falls, PA 15010-4213
Phone (724) 843-1870

Other identifiers 2

IdentifierTypeStateIssuer
0009693170001MedicaidPA
410001500OtherPAMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100913000080 PA Practitioner - Optometry 6002903770 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist CurrentSince Jan 15, 2019 Accepting new patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist CurrentSince Jan 15, 2019 Accepting new patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist Current Accepting new patients

Locations

1315 6th Ave
Beaver Falls, PA 15010
Phone (724) 843-1870

125 S Antrim Way
Greencastle, PA 17225
Phone (717) 597-4780

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1922097153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 6TH AVE",
            "city": "BEAVER FALLS",
            "state": "PA",
            "postal_code": "150104213",
            "telephone_number": "724-843-1870",
            "fax_number": "724-843-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 6TH AVE",
            "city": "BEAVER FALLS",
            "state": "PA",
            "postal_code": "150104213",
            "telephone_number": "724-843-1870",
            "fax_number": "724-843-7275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVRANEK",
        "first_name": "GARY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009693170001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "410001500",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver Falls, PA

Sources for this page

Verify at the official NPI Registry.