{
"Npi": {
"NPI": "1497289680",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "OPTHALMIC ASSOCIATES",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "120 MAIN STREET",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JOHNSTOWN",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "15901-1578",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "814-536-5343",
"MailingAddressFaxNumber": "814-536-1525",
"FirstLinePracticeLocationAddress": "200 HOSPITAL DRIVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MEYERSDALE",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "15552-1249",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "814-972-6933",
"PracticeLocationAddressFaxNumber": "814-634-0435",
"EnumerationDate": "04/14/2017",
"LastUpdateDate": "04/14/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "POLITO",
"AuthorizedOfficialFirstName": "JOSEPH",
"AuthorizedOfficialMiddleName": "R",
"AuthorizedOfficialTitle": "OPTHALMOLOGIST/PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "814-536-5343",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207W00000X",
"TaxonomyName": "Ophthalmology Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}