PRIMARY EYE CARE CENTER PC
NPI 1205015815
Optometrist in Elizabethtown, PA
About Primary Eye Care Center Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRIMARY EYE CARE CENTER PC (NPI 1205015815) is a healthcare organization registered as an optometrist in Elizabethtown, Pennsylvania and active in the NPI registry since October 2007. The organization lists Ty M Graden, Optometrist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Primary Eye Care Center Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Primary Eye Care Center PC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Elizabethtown, PA 17022
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Primary Eye Care Center PC's NPI number?
The NPI number for Primary Eye Care Center PC is 1205015815. It was assigned to this organization in the NPPES registry on October 31, 2007.
Where is Primary Eye Care Center PC located?
Primary Eye Care Center PC is located at 405 S Market St, Elizabethtown, PA 17022. The listed phone number is (717) 367-1883.
What is Primary Eye Care Center PC's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Primary Eye Care Center PC enrolled in Medicare?
Yes. Primary Eye Care Center PC is registered in the Medicare PECOS enrollment system.
When is Primary Eye Care Center PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Pennsylvania, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Primary Eye Care Center PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Primary Eye Care Center PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Primary Eye Care Center PC was last updated on March 28, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Primary Eye Care Center Pc · NPI 1205015815
Optometrist organization in Elizabethtown, Pennsylvania. Organization record, active in the CMS NPPES registry since October 31, 2007.
## Identity
- **NPI:** 1205015815 (Entity type: Organization)
- **Enumerated:** October 31, 2007
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Organization subpart:** No
- **Authorized official:** Ty Graden, OPTOMETRIST
## Practice location
- **Address:** 405 S MARKET ST, Elizabethtown, PA 17022
- **Phone:** (717) 367-1883 · **Fax:** (717) 367-1884
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Pennsylvania, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Optometry) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 28, 2011
- **Other identifiers:** Medicare PIN 188585 (PA)
---
Source: [NPI Profile](https://npiprofile.com/npi/1205015815) · Data from the CMS NPPES public registry.