Organization Active NPI

Edwin M Schott OD PC

  • Optometrist
  • Port Allegany, PA
National Provider Identifier
1962455352
Registry record updated Dec 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000103 Issued in PA
Legal business name
EDWIN M SCHOTT OD PC
Practice address
21 Willow St
Port Allegany, PA 16743-1334
Phone
(814) 642-9408
Fax
(814) 642-9484
NPI assigned
May 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2008

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

Authorized official

Name
Edwin Schott
Title
President
Phone
(814) 642-9408

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X OEG000103 PA Primary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X OEG001451 PA

Addresses

Primary practice location

21 Willow St
Port Allegany, PA 16743-1334

Mailing address

21 Willow St
Port Allegany, PA 16743-1334
Phone (814) 642-9408

Other identifiers 1

IdentifierTypeStateIssuer
SC835524OtherPAHIGHMARK GRP

Other names 1

  • Schott Associates Eye Care Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041102000090 PA Part B Supplier - Clinic/Group Practice 7416919477 Receives reassigned benefits from 1 practitioner
Practice locations: Port Allegany, PA; Coudersport, PA
O20100930075746 PA DME Supplier - Physician - Optometrist 7416919477 Practice locations: Port Allegany, PA

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
Schott Associates Eyecare21 Willow St, Port Allegany, PA 16743-1334(814) 642-9408 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 2006

National Provider Directory

National Provider Directory

Locations

125 Main St
Rm 201
Bradford, PA 16701
Phone (814) 368-7144

1001 E 2nd St
Ste A
Coudersport, PA 16915

12 E 4th St
Emporium, PA 15834
Phone (814) 486-2700

21 Willow St
Port Allegany, PA 16743
Phone (814) 642-9408

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229731200000",
    "number": "1962455352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WILLOW ST",
            "city": "PORT ALLEGANY",
            "state": "PA",
            "postal_code": "167431334",
            "telephone_number": "814-642-9408",
            "fax_number": "814-642-9484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WILLOW ST",
            "city": "PORT ALLEGANY",
            "state": "PA",
            "postal_code": "167431334",
            "telephone_number": "814-642-9408",
            "fax_number": "814-642-9484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWIN M SCHOTT OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2008-12-20",
        "status": "A",
        "authorized_official_last_name": "SCHOTT",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-642-9408"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000103",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001451",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK GRP",
            "identifier": "SC835524",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Schott Associates Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Allegany, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.