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DR. JAMES PAUL HENNINGER O.D.
NPI 1174615983
Optometrist in Kulpmont, PA

Active since September 29, 2006PECOS EnrolledAccepts Medicare Assignment
963 CHESTNUT ST OFC B, KULPMONT, PA 17834(570) 373-1015(570) 373-1023 Get Directions Write a Review

NPPES record last updated: April 3, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. James Paul Henninger O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JAMES PAUL HENNINGER O.D. (NPI 1174615983) is an individual optometrist in Kulpmont, Pennsylvania, licensed in Pennsylvania (OEG001609) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS and is a graduate of Pennsylvania College Of Optometry (1983).

NPPES Registry Identity

NPI1174615983
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. JAMES PAUL HENNINGERCredential: O.D.
Location Address963 CHESTNUT ST OFC BKulpmont, PA 17834-1248
Mailing Address50 N Maple StMount Carmel, PA 17851-1300 · (570) 339-2300 · Fax (570) 339-6011
Phone(570) 373-1015
Fax(570) 373-1023
Sole ProprietorYes
Medical School CMSPennsylvania College Of OptometryGraduated 1983
Enumeration DateSeptember 29, 2006
Last NPPES UpdateApril 3, 2024
NPPES CertifiedApril 3, 2024
✔ NPI 1174615983 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in PA · OEG001609
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
963 CHESTNUT ST OFC B, Kulpmont, PA 17834
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. James Paul Henninger O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID648394049
PECOS Enrollment IDI20100907000672
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 17834 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is James Henninger's NPI number?

The NPI number for James Henninger is 1174615983. It was assigned to this individual provider in the NPPES registry on September 29, 2006.

Where is James Henninger located?

James Henninger practices at 963 Chestnut St Ofc B, Kulpmont, PA 17834. The listed phone number is (570) 373-1015.

What is James Henninger's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is James Henninger enrolled in Medicare?

Yes. James Henninger is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does James Henninger accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 4 other insurers list James Henninger as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for James Henninger was last updated on April 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.