DR. JACQUELINE R CARRASCO (NPI# 1336148410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336148410 |
| Entity Type | Individual |
| Full Name | DR. JACQUELINE R CARRASCO |
| Credential | MD |
| Practice Address |
100 E Lancaster Ave Ste 54 Wynnewood PA 19096-3438 |
| Practice Telephone | 6106491970 |
| Mailing Telephone | 6106491970 |
| Mailing Fax Number | 6106498624 |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2020-07-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | 25MA07455900 | NJ | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | MD416985 | PA | Allopathic & Osteopathic Physicians |
| Y | 207WX0200X |
Ophthalmology Specialization: Ophthalmic Plastic and Reconstructive Surgery |
MD416985 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 101226829001 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639520661 | Jacqueline Carrasco | Counselor | 550 South Vermont Ave, 10th Floor, Los Angeles, CA 90020 | 2016-06-30 |
| Street Address |
100 E LANCASTER AVE STE 54 |
| City | WYNNEWOOD |
| State | PA |
| Zip Code | 19096-3438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831727866 | Jeffrey Glenn Johnston | Hospitalist | Lankenau Medical Center. 100 E Lancaster Ave, Wynnewood, PA 19096 | 2020-03-27 |
| 1326500331 | Maitri Pancholy | Student in an Organized Health Care Education/Training Program | Annenberg Center, G-10, 100 Lancaster Avenue, Wynnewood, PA 19096 | 2019-04-01 |
| 1306355987 | Karie Elizabeth Melton | Social Worker | 250 E Wynnewood Rd E12, Wynnewood, PA 19096 | 2017-09-26 |
| 1518320662 | Kaitlyn Kennard | Surgery | 100 Lancaster Ave Mob South Suite 422, Wynnewood, PA 19096 | 2016-04-05 |
| 1366814675 | Linda Elkins | Counselor | 543 Haverford Rd, Wynnewood, PA 19096 | 2015-10-26 |
| 1619347655 | Tessa Kovick | Registered Nurse | 100 E Lancaster Ave Ste 114, Wynnewood, PA 19096 | 2015-10-02 |
| 1922476415 | Amy Lenrow | Skilled Nursing Facility | 1510 Powder Mill Lane, Wynnewood, PA 19096 | 2015-09-14 |
| 1144602855 | Casey Dajao | Internal Medicine | 100 E Lancaster Ave Ste 140, Wynnewood, PA 19096 | 2015-06-18 |
| 1649666223 | Benjamin Larson | Internal Medicine | 100 E Lancaster Ave Ste B11, Wynnewood, PA 19096 | 2015-04-10 |
| 1760873285 | Kathleen Gilmartin | Nurse Practitioner | 100 East Lancaster Ave, Wynnewood, PA 19096 | 2015-02-06 |
| Find all providers in zip 19096 | ||||
| Taxonomy Code | 207WX0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Ophthalmic Plastic and Reconstructive Surgery |
| A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit, eyelid, and lacrimal system. Practitioners evaluate, diagnose and treat conditions involving the eyelids, brows, midface, orbits, lacrimal systems and surrounding and supporting structures of the face and neck. |
| Notes: Source: American Academy of Ophthalmology, 2015. www.aao.org [1/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609353291 | Eye and Facial Plastic Surgery Consultants LLC | Ophthalmology | 1203 Newtown-langhorne Road, Suite 120, Langhorne, PA 19047 | 2018-07-26 |
| 1669529780 | Paul B Johnson | Ophthalmology | 1923 Mount Vernon St, Philadelphia, PA 19130-3213 | 2007-01-03 |
| 1881685048 | Daniel E Buerger | Ophthalmology | 5750 Centre Ave Ste 230, Pittsburgh, PA 15206-3761 | 2005-11-04 |
| 1477948412 | Siwei Zhou | Ophthalmology | 840 Walnut St Ste 910, Philadelphia, PA 19107-5599 | 2015-04-06 |
| 1548689425 | Sana Ali Bautista | Ophthalmology | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2014-04-08 |
| 1811064561 | Pittsburgh Oculoplastic Associates, Ltd | Ophthalmology | 5750 Centre Ave Ste 230, Pittsburgh, PA 15206-3761 | 2006-11-29 |
| 1841240827 | Cari Elizabeth Lyle | Ophthalmology | 5750 Centre Ave Ste 230, Pittsburgh, PA 15206-3761 | 2006-05-11 |
| 1568443166 | Phillip Hyunchul Choo | Ophthalmology | 5750 Centre Ave Ste 230, Pittsburgh, PA 15206-3761 | 2005-11-10 |
| 1730160631 | David G Buerger | Ophthalmology | 5750 Centre Ave Ste 230, Pittsburgh, PA 15206-3761 | 2005-11-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.