MEDICARE: DR. JON L MARBERGER OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OEG000871	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	410003187	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	21183407558	OTHER	PA	BEECH STREET
3	277623	OTHER	PA	MAMSI
4	1957331	OTHER	PA	UNITED HEALTHCARE
5	J48917	OTHER	PA	AMERIHEALTH OF PA
6	86526166	OTHER	PA	BCBS OF AL
7	EYEMED	OTHER	PA	116943
8	232340228	OTHER	PA	TAX ID
9	2263894	OTHER	PA	AETNA

General Provider Information

NPI Number	:	1770586687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JON L MARBERGER OD

Provider Business Mailing Address
First Line	:	PO BOX 429
Second Line	:
City	:	GLENSIDE
State	:	PA
Zip	:	19038-0429
Country	:	US
Telephone Number	:	267-254-2449
Fax Number	:	215-886-6892

Provider Business Practice Location Address
First Line	:	130 EAST GLENSIDE AVE
Second Line	:
City	:	GLENSIDE
State	:	PA
Zip	:	19038
Country	:	US
Telephone Number	:	267-254-2449
Fax Number	:	844-350-6309

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	12/10/2025

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Directions to “ DR. JON L MARBERGER OD” Practice Location

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