Individual provider Active NPI

Kathryn Elizabeth Clare, OD

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1972987279
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003088 Issued in PA
Practice address
3400 Civic Center Blvd
West Pavilion, 3Rd Floor
Philadelphia, PA 19104-5127
Phone
(215) 614-4100
Fax
(215) 615-0527
NPI assigned
Jul 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00703400 NJ
Corneal and Contact Management Optometrist 152WC0802X OEG003088 PA
Low Vision Rehabilitation Optometrist 152WL0500X OEG003088 PA
Occupational Vision Optometrist 152WX0102X OEG003088 PA
Optometrist 152W00000X OEG003088 PA Primary

Addresses

Primary practice location

3400 Civic Center Blvd
West Pavilion, 3Rd Floor
Philadelphia, PA 19104-5127

Mailing address

51 North 39TH Street
Philadelphia, PA 19104-2689
Phone (215) 614-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160816001783 PA Practitioner - Optometry 3072807957 Reassigns benefits to 1 organization
I20250306001141 NJ Practitioner - Optometry 3072807957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Civic Ctr Blvd
Philadelphia, PA 19104-5127
Phone (215) 614-4100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00703400NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Apr 1, 2025 Accepting new patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Apr 1, 2025 Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Apr 1, 2025 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Apr 1, 2025 Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

975 Route 73 N
Ste B
Marlton, NJ 08053
Phone (609) 495-2522

975 Route 73 N
Marlton, NJ 08053
Phone (609) 910-0270

1006 Mantua Pike
Woodbury Hts, NJ 08097
Phone (856) 845-6880

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3400 Civic Center Blvd
#3W
Philadelphia, PA 19104
Phone (215) 615-0063

3400 Civic Center Blvd
Fl 3
Philadelphia, PA 19104
Phone (215) 614-4100

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1972987279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 NORTH 39TH STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042689",
            "telephone_number": "215-614-4100",
            "fax_number": "215-615-0527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "WEST PAVILION, 3RD FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-614-4100",
            "fax_number": "215-615-0527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARE",
        "first_name": "KATHRYN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-16",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00703400",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "PA",
            "license": "OEG003088",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "PA",
            "license": "OEG003088",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "PA",
            "license": "OEG003088",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.