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VISION INNOVATION CENTERS OF PENNSYLVANIA LLC
NPI 1962046458
Ophthalmology in Kingston, PA

Active since October 29, 2019
703 RUTTER AVE, KINGSTON, PA 18704(410) 571-8733 Get Directions Write a Review

NPPES record last updated: April 9, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 9, 2026, Mar 7, 2025, Mar 17, 2023 and 5 more (8 updates tracked since 2019).

About Vision Innovation Centers Of Pennsylvania Llc NPPES

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

VISION INNOVATION CENTERS OF PENNSYLVANIA LLC (NPI 1962046458) is a healthcare organization registered as an ophthalmology in Kingston, Pennsylvania and active in the NPI registry since October 2019. The organization maintains 18 additional practice locations and lists Michael Pascetta, Cfo, as its authorized official.

NPPES Registry Identity

NPI1962046458
Entity TypeOrganization
Primary Taxonomy207W00000X
Legal Business NameVISION INNOVATION CENTERS OF PENNSYLVANIA LLC
Location Address703 RUTTER AVEKingston, PA 18704-4801
Mailing Address703 Rutter AveKingston, PA 18704-4801
Phone(410) 571-8733
Organization SubpartNo
Authorized OfficialMichael PascettaCfo · (860) 652-5002
Enumeration DateOctober 29, 2019
Last NPPES UpdateApril 9, 20268 updates tracked since enumeration
NPPES CertifiedApril 9, 2026
✔ NPI 1962046458 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
703 RUTTER AVE, Kingston, PA 18704
Open in Google Maps ↗

Secondary Practice Locations 18

Location 11850 South Twp BlvdPittston, PA 18640-3550 · Phone (570) 654-1641
Location 210 1/2 S Mountain BlvdMountain Top, PA 18707-1123 · Phone (570) 403-1341
Location 3569 Hamlin HwyHamlin, PA 18427-7000 · Phone (571) 689-2525
Location 4174 Harvest Ln Ste 3Pocono Summit, PA 18346-7761 · Phone (570) 839-7973
Location 5304 W Tioga StTunkhannock, PA 18657-6615 · Phone (570) 836-2224
Location 6625 Park StreetHonesdale, PA 18431 · Phone (570) 253-1720
Location 72657 PA Route 940Pocono Summit, PA 18346-5001 · Phone (570) 839-7973
Location 81582 Main StPeckville, PA 18452-2029 · Phone (570) 278-2279
Location 9190 Welles StForty Fort, PA 18704-4968 · Phone (570) 718-0590
Location 10215 Georgian PlSomerset, PA 15501-1610 · Phone (814) 445-3730
Location 111318 Eisenhower BlvdJohnstown, PA 15904-3307 · Phone (814) 266-2027
Location 124407 Carlisle PikeCamp Hill, PA 17011-4159 · Phone (717) 975-2015
Location 13301 Penn AveWest Reading, PA 19611-1262 · Phone (610) 372-2222
Location 144100 Linglestown RdHarrisburg, PA 17112-1071 · Phone (717) 996-3028
Location 15503 S State StClarks Summit, PA 18411-1557 · Phone (570) 587-5186
Location 16200 Mifflin AveScranton, PA 18503-1982 · Phone (855) 204-6888
Location 1716749 State Route 706 Ste 4Montrose, PA 18801-6502 · Phone (570) 278-2279
Location 18120 Main StJohnstown, PA 15901-1507 · Phone (814) 536-5343

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

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)

Vision Innovation Centers Of Pennsylvania Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 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.

StateEnrollment IDDue date
StatePennsylvaniaEnrollment IDO20200213000641DME · Physician - OptometristDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

88

Medicare enrollment records show 88 clinicians reassign Medicare billing to Vision Innovation Centers Of Pennsylvania LLC, which bills Medicare for the services they deliver. Of these, 21 practice at this address and 25 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 2

Optometry55
Ophthalmology33

Nearest to this location (20)

See all 88
Anthony Andrews, MD
Ophthalmology
NPI 1457348781
703 RUTTER AVE
Kingston, PA 18704
(570) 288-7405
✔ PECOS✔ Accepts MedicareSame address
Thomas Armstrong, OD
Optometry
NPI 1265263933
703 RUTTER AVE
Kingston, PA 18704
(570) 288-7405
✔ PECOS✔ Accepts MedicareSame address
Jerard Brown, OD
Optometry
NPI 1376539916
703 RUTTER AVE
Kingston, PA 18704
(570) 288-7405
✔ PECOS✔ Accepts MedicareSame address
Carrie Cardillo, O.D.
Optometry
NPI 1053413633
703 RUTTER AVE
Kingston, PA 18704
(570) 288-7405
✔ PECOS✔ Accepts MedicareSame address
Jeffrey Empfield, OD
Optometry
NPI 1245299064
703 RUTTER AVE
Kingston, PA 18704
(570) 288-7405
✔ PECOS✔ Accepts MedicareSame address
Tara Farrell, O.D.
Optometry
NPI 1306049598
703 RUTTER AVE
Kingston, PA 18704
(570) 288-7405
✔ PECOS✔ Accepts MedicareSame address
Michael Fasano, DO
Ophthalmology
NPI 1548827918
703 RUTTER AVE
Kingston, PA 18704
(570) 288-7405
✔ PECOS✔ Accepts MedicareSame address
Bradley Foster, MD
Ophthalmology
NPI 1801882667
703 RUTTER AVE
Kingston, PA 18704
(570) 288-7405
✔ PECOS✔ Accepts MedicareSame address
Mark Grohol, OD
Optometry
NPI 1447271473
703 RUTTER AVE
Kingston, PA 18704
(570) 288-7405
✔ PECOS✔ Accepts MedicareSame address
Susana Gutierrez, OD
Optometry
NPI 1881426443
703 RUTTER AVE
Kingston, PA 18704
(570) 288-7405
✔ PECOS✔ Accepts MedicareSame address
Michael Havrilla, OD
Optometry
NPI 1336109503
703 RUTTER AVE
Kingston, PA 18704
(570) 288-7405
✔ PECOS✔ Accepts MedicareSame address
Michael Josefowicz, OD
Optometry
NPI 1164465795
703 RUTTER AVE
Kingston, PA 18704
(570) 288-7405
✔ PECOS✔ Accepts MedicareSame address
Robert Lloyd, OD
Optometry
NPI 1487760211
703 RUTTER AVE
Kingston, PA 18704
(570) 288-7405
✔ PECOS✔ Accepts MedicareSame address
Richard Roth, DO
Ophthalmology
NPI 1366449977
703 RUTTER AVE
Kingston, PA 18704
(570) 288-7405
✔ PECOS✔ Accepts MedicareSame address
Alexandra Stevens, OD
Optometry
NPI 1699482760
703 RUTTER AVE
Kingston, PA 18704
(570) 288-7405
✔ PECOS✔ Accepts MedicareSame address
Daniel Lutz, M.D.
Ophthalmology
NPI 1386846251
703 RUTTER AVE
Kingston, PA 18704
(570) 288-7405
✔ PECOS✔ Accepts MedicareSame address
Harvey Reiser, MD
Ophthalmology
NPI 1376502229
703 RUTTER AVE
Kingston, PA 18704
(570) 288-7405
✔ PECOS✔ Accepts MedicareSame address
Robert Szulborski, MD
Ophthalmology
NPI 1437119799
703 RUTTER AVE
Kingston, PA 18704
(570) 288-7405
✔ PECOS✔ Accepts MedicareSame address
Michele Wasilauski, OD
Optometry
NPI 1730149915
703 RUTTER AVE
Kingston, PA 18704
(570) 288-7405
✔ PECOS✔ Accepts MedicareSame address
Diane Delregno, OD
Optometry
NPI 1023077849
703 RUTTER AVE
Kingston, PA 18704
(570) 288-7405
✔ PECOS✔ Accepts MedicareSame address
See all 88 clinicians

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 Vision Innovation Centers Of Pennsylvania LLC's NPI number?

The NPI number for Vision Innovation Centers Of Pennsylvania LLC is 1962046458. It was assigned to this organization in the NPPES registry on October 29, 2019.

Where is Vision Innovation Centers Of Pennsylvania LLC located?

Vision Innovation Centers Of Pennsylvania LLC is located at 703 Rutter Ave, Kingston, PA 18704. The listed phone number is (410) 571-8733.

What is Vision Innovation Centers Of Pennsylvania LLC's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Vision Innovation Centers Of Pennsylvania LLC enrolled in Medicare?

Yes. Vision Innovation Centers Of Pennsylvania LLC is registered in the Medicare PECOS enrollment system.

When is Vision Innovation Centers Of Pennsylvania LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Pennsylvania, Physician - Optometrist) is due for revalidation by February 28, 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 Vision Innovation Centers Of Pennsylvania LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 88 clinicians in 2 Medicare specialties reassign their Medicare billing to Vision Innovation Centers Of Pennsylvania LLC. 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. The largest specialties are Optometry (55) and Ophthalmology (33). Of these, 21 practice at this address and 25 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Vision Innovation Centers Of Pennsylvania LLC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Buckeye Health Plan, Anthem Blue Cross and Blue Shield and Blue Cross and Blue Shield of Louisiana and 4 other insurers list Vision Innovation Centers Of Pennsylvania LLC 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 Vision Innovation Centers Of Pennsylvania LLC was last updated on April 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.