Individual provider Active NPI

Emily Helen Eisenhower, OD

  • Optometrist
  • Palmyra, PA
National Provider Identifier
1932879004
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003852 Issued in PA
Practice address
2901 Horseshoe Pike
Palmyra, PA 17078-9040
Phone
(717) 473-3802
Fax
(717) 641-3074
NPI assigned
Sep 20, 2021
Last updated
Sep 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003852 PA Primary

Addresses

Primary practice location

2901 Horseshoe Pike
Palmyra, PA 17078-9040

Mailing address

2901 Horseshoe Pike
Palmyra, PA 17078-9040
Phone (717) 473-3802

Other practice location 1

758 Cumberland St
Lebanon, PA 17042-5247
Phone (717) 473-3802

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
I20210928003744 PA Practitioner - Optometry 8426455742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Corl Eyecare, LLCGroup PAC ID 2365787561, 4 clinicians

Practice addresses (Care Compare)

2901 Horseshoe Pike
Palmyra, PA 17078-9040
Phone 71747338021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Corl Eyecare, LLC Optometrist CurrentSince Sep 21, 2021 Accepting new patients
Timothy R. Corl OD, PC Optometrist CurrentSince Sep 21, 2021 Accepting new patients

Locations

758 Cumberland St
Lebanon, PA 17042
Phone (717) 473-3802

2901 Horseshoe Pike
Palmyra, PA 17078
Phone (717) 473-3802

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1932879004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 HORSESHOE PIKE",
            "city": "PALMYRA",
            "state": "PA",
            "postal_code": "170789040",
            "telephone_number": "717-473-3802",
            "fax_number": "717-641-3074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 HORSESHOE PIKE",
            "city": "PALMYRA",
            "state": "PA",
            "postal_code": "170789040",
            "telephone_number": "717-473-3802",
            "fax_number": "717-641-3074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "758 Cumberland St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170425247",
            "country_code": "US",
            "telephone_number": "717-473-3802",
            "fax_number": "717-641-3074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EISENHOWER",
        "first_name": "EMILY",
        "middle_name": "HELEN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-20",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmyra, PA

Sources for this page

Verify at the official NPI Registry.