Provider Demographics
NPI:1336158971
Name:BUCKS-MONT EYE ASSOCIATES, PC
Entity Type:Organization
Organization Name:BUCKS-MONT EYE ASSOCIATES, PC
Other - Org Name:BUCKS MONT EYE ASSOCIATES OR PENNRIDGE OPTICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:215-257-8053
Mailing Address - Street 1:711 LAWN AVE
Mailing Address - Street 2:
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960-1575
Mailing Address - Country:US
Mailing Address - Phone:215-257-8053
Mailing Address - Fax:215-257-2020
Practice Address - Street 1:711 LAWN AVE
Practice Address - Street 2:
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960-1575
Practice Address - Country:US
Practice Address - Phone:215-257-8053
Practice Address - Fax:215-257-2020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000562272OtherHIGHMARK BLUE SHIELD (MD)
PA0795136000OtherKEYSTONE/BCBS (MD)
PA1012967OtherKEYSTONE MERCY
PACB6279OtherRAILROAD MEDICARE
PA000562096OtherHIGHMARK BLUE SHIELD (OD)
PA1007664240006Medicaid
PA2513096OtherAETNA US HEALTHCARE
PA0795010000OtherKEYSTONE/BCBS (OD)
PA045969Medicare PIN
PA000562096OtherHIGHMARK BLUE SHIELD (OD)