Clayton M. Anderson, Jr. O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

CLAYTON M. ANDERSON, JR. O.D.

Practice address

701 Lincoln Ave
N Charleroi, PA 15022-2422

Phone

(724) 483-8055

Fax

(724) 483-6541

NPI assigned

Feb 21, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Clayton M. Anderson Jr., O.D.

Title

Optometrist/Owner

Phone

(724) 547-6130

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Clayton M. Anderson, Jr. O.D.

  • Optometrist
  • Mt Pleasant, PA
  • NPI 1427227727

  0547389264

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Clayton Manning Anderson Jr., OD

  • Optometrist
  • Mt Pleasant, PA
  • NPI 1093827149

  O20100930043956

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1932378239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 LINCOLN AVE",
            "city": "N CHARLEROI",
            "state": "PA",
            "postal_code": "150222422",
            "telephone_number": "724-483-8055",
            "fax_number": "724-483-6541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 LINCOLN AVE",
            "city": "N CHARLEROI",
            "state": "PA",
            "postal_code": "150222422",
            "telephone_number": "724-483-8055",
            "fax_number": "724-483-6541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAYTON M. ANDERSON, JR. O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-21",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "724-547-6130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AN146070",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "0013245",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "391975",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "77513",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLE/EYEMED",
            "identifier": "PA0579",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS",
            "identifier": "50551",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Advantage Rehabilitation Staffing, LLC
• Matthew Victor Bair, PT
• Marc N Biagini, D.C.
• Rhya Bianchi, OT
• Ashley Conjeski, OT
• Rachel Falls, SP
• Laura M Henninger, PT
• Kenneth Lentz, MD
• Anna Prendergast, OT

• Optometrist in N Charleroi, PA
• Providers in N Charleroi, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.