Peter G Theodorous, OD is a medicare enrolled "Optometrist" provider in Spring Mills, Pennsylvania. His current practice location is
4570 Penns Valley Rd, Suite 3, Spring Mills, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at
(814) 422-8006.
Peter G Theodorous is licensed to practice in Pennsylvania (license number OEG000709) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1407843535.
Healthcare Provider's Profile
Full Name | Peter G Theodorous |
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Gender | Male |
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Speciality | Optometrist |
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Location | 4570 Penns Valley Rd, Spring Mills, Pennsylvania |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1407843535
- Provider Enumeration Date: 10/04/2005
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 8729154992
- Enrollment ID: I20080918000034
Medical Identifiers
Medical identifiers for Peter G Theodorous such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1407843535 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
152W00000X | Optometrist | OEG000709 (Pennsylvania) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Peter G Theodorous is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Peter G Theodorous, OD 428 Windmere Dr, Suite 100, State College, PA 16801-7668 Ph: (814) 234-2015 | Peter G Theodorous, OD 4570 Penns Valley Rd, Suite 3, Spring Mills, PA 16875-8500 Ph: (814) 422-8006 |
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