NPIMap

Organization Active NPI

Vision Innovation Centers of Pennsylvania LLC

  • Ophthalmology Physician
  • Kingston, PA
National Provider Identifier
1962046458
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
VISION INNOVATION CENTERS OF PENNSYLVANIA LLC
Practice address
703 Rutter Ave
Kingston, PA 18704-4801
Phone
(410) 571-8733
NPI assigned
Oct 29, 2019
Last updated
Apr 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Authorized official

Name
Michael Pascetta
Title
Cfo
Phone
(860) 652-5002

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

703 Rutter Ave
Kingston, PA 18704-4801

Mailing address

703 Rutter Ave
Kingston, PA 18704-4801

Other practice location 1

1850 South Twp Blvd
Pittston, PA 18640-3550
Phone (570) 654-1641

Other practice location 2

10 1/2 S Mountain Blvd
Mountain Top, PA 18707-1123
Phone (570) 403-1341

Other practice location 3

569 Hamlin Hwy
Hamlin, PA 18427-7000
Phone (571) 689-2525

Other practice location 4

174 Harvest Ln Ste 3
Pocono Summit, PA 18346-7761
Phone (570) 839-7973

Other practice location 5

304 W Tioga St
Tunkhannock, PA 18657-6615
Phone (570) 836-2224

Other practice location 6

625 Park Street
Honesdale, PA 18431
Phone (570) 253-1720

Other practice location 7

2657 PA Route 940
Pocono Summit, PA 18346-5001
Phone (570) 839-7973

Other practice location 8

1582 Main St
Peckville, PA 18452-2029
Phone (570) 278-2279

Other practice location 9

190 Welles St
Forty Fort, PA 18704-4968
Phone (570) 718-0590

Other practice location 10

120 Main St
Johnstown, PA 15901-1507
Phone (814) 536-5343

Other practice location 11

215 Georgian Pl
Somerset, PA 15501-1610
Phone (814) 445-3730

Other practice location 12

4407 Carlisle Pike
Camp Hill, PA 17011-4159
Phone (717) 975-2015

Other practice location 13

301 Penn Ave
West Reading, PA 19611-1262
Phone (610) 372-2222

Other practice location 14

4100 Linglestown Rd
Harrisburg, PA 17112-1071
Phone (717) 996-3028

Other practice location 15

503 S State St
Clarks Summit, PA 18411-1557
Phone (570) 587-5186

Other practice location 16

200 Mifflin Ave
Scranton, PA 18503-1982
Phone (855) 204-6888

Other practice location 17

16749 State Route 706 Ste 4
Montrose, PA 18801-6502
Phone (570) 278-2279

Other practice location 18

1318 Eisenhower Blvd
Johnstown, PA 15904-3307
Phone (814) 266-2027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200110000050 PA Part B Supplier - Clinic/Group Practice 0840625349 Receives reassigned benefits from 88 practitioners
8 other NPIs on this enrollment
Practice locations: Somerset, PA; Mountain Top, PA; Nanticoke, PA; Peckville, PA; Pittston, PA; Pocono Summit, PA; Reading, PA; Scranton, PA…
O20200213000641 PA DME Supplier - Physician - Optometrist 0840625349 Practice locations: Kingston, PA

Other NPIs with the same Medicare PAC ID 20

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

View all 20

Other NPIs on the same Medicare enrollment 8

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

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Vision Innovation Centers of PA703 Rutter Ave, Kingston, PA 18704-4801(570) 288-7405 Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 2020

National Provider Directory

National Provider Directory

Locations

126 W Front St
Berwick, PA 18603
Phone (570) 752-7458

4407 Carlisle Pike
Ste D
Camp Hill, PA 17011
Phone (717) 975-2015

204 Mifflin Ave
Scranton, PA 18503
Phone (570) 342-3145

711 Lawn Ave
Ste 3
Sellersville, PA 18960
Phone (215) 257-8053

Practitioners & affiliated clinicians

Practitioners 88

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 88

NPI Registry JSON

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775692800000",
    "number": "1962046458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 RUTTER AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187044801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 RUTTER AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187044801",
            "telephone_number": "410-571-8733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1850 South Twp Blvd",
            "address_purpose": "LOCATION",
            "city": "Pittston",
            "state": "PA",
            "postal_code": "186403550",
            "country_code": "US",
            "telephone_number": "570-654-1641",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 1/2 S Mountain Blvd",
            "address_purpose": "LOCATION",
            "city": "Mountain Top",
            "state": "PA",
            "postal_code": "187071123",
            "country_code": "US",
            "telephone_number": "570-403-1341",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "569 Hamlin Hwy",
            "address_purpose": "LOCATION",
            "city": "Hamlin",
            "state": "PA",
            "postal_code": "184277000",
            "country_code": "US",
            "telephone_number": "571-689-2525",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "174 Harvest Ln Ste 3",
            "address_purpose": "LOCATION",
            "city": "Pocono Summit",
            "state": "PA",
            "postal_code": "183467761",
            "country_code": "US",
            "telephone_number": "570-839-7973",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "304 W Tioga St",
            "address_purpose": "LOCATION",
            "city": "Tunkhannock",
            "state": "PA",
            "postal_code": "186576615",
            "country_code": "US",
            "telephone_number": "570-836-2224",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "625 Park Street",
            "address_purpose": "LOCATION",
            "city": "Honesdale",
            "state": "PA",
            "postal_code": "18431",
            "country_code": "US",
            "telephone_number": "570-253-1720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2657 PA Route 940",
            "address_purpose": "LOCATION",
            "city": "Pocono Summit",
            "state": "PA",
            "postal_code": "183465001",
            "country_code": "US",
            "telephone_number": "570-839-7973",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1582 Main St",
            "address_purpose": "LOCATION",
            "city": "Peckville",
            "state": "PA",
            "postal_code": "184522029",
            "country_code": "US",
            "telephone_number": "570-278-2279",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "190 Welles St",
            "address_purpose": "LOCATION",
            "city": "Forty Fort",
            "state": "PA",
            "postal_code": "187044968",
            "country_code": "US",
            "telephone_number": "570-718-0590",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 Main St",
            "address_purpose": "LOCATION",
            "city": "Johnstown",
            "state": "PA",
            "postal_code": "159011507",
            "country_code": "US",
            "telephone_number": "814-536-5343",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "215 Georgian Pl",
            "address_purpose": "LOCATION",
            "city": "Somerset",
            "state": "PA",
            "postal_code": "155011610",
            "country_code": "US",
            "telephone_number": "814-445-3730",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4407 Carlisle Pike",
            "address_purpose": "LOCATION",
            "city": "Camp Hill",
            "state": "PA",
            "postal_code": "170114159",
            "country_code": "US",
            "telephone_number": "717-975-2015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Penn Ave",
            "address_purpose": "LOCATION",
            "city": "West Reading",
            "state": "PA",
            "postal_code": "196111262",
            "country_code": "US",
            "telephone_number": "610-372-2222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4100 Linglestown Rd",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171121071",
            "country_code": "US",
            "telephone_number": "717-996-3028",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "503 S State St",
            "address_purpose": "LOCATION",
            "city": "Clarks Summit",
            "state": "PA",
            "postal_code": "184111557",
            "country_code": "US",
            "telephone_number": "570-587-5186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Mifflin Ave",
            "address_purpose": "LOCATION",
            "city": "Scranton",
            "state": "PA",
            "postal_code": "185031982",
            "country_code": "US",
            "telephone_number": "855-204-6888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16749 State Route 706 Ste 4",
            "address_purpose": "LOCATION",
            "city": "Montrose",
            "state": "PA",
            "postal_code": "188016502",
            "country_code": "US",
            "telephone_number": "570-278-2279",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1318 Eisenhower Blvd",
            "address_purpose": "LOCATION",
            "city": "Johnstown",
            "state": "PA",
            "postal_code": "159043307",
            "country_code": "US",
            "telephone_number": "814-266-2027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VISION INNOVATION CENTERS OF PENNSYLVANIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-29",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A",
        "authorized_official_last_name": "PASCETTA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "860-652-5002"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.