| Eye Surgical Medical Associates Pc | |
| 8118 Bustleton Ave, Phila, PA 19152-2803 | |
| (215) 342-8118 | |
| (215) 725-4999 | 
| Full Name | Eye Surgical Medical Associates Pc | 
|---|---|
| Type | Facility | 
| Speciality | Ophthalmology | 
| Location | 8118 Bustleton Ave, Phila, Pennsylvania | 
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1558305219 | NPI | - | NPPES | 
| 890541 | Other | PA | HIGHMARK BLUE SHIELD | 
| 00531400000 | Other | PA | DENNIS J KHOURY MD | 
| 0010888550007 | Medicaid | PA | |
| 114458 | Other | PA | HIGHMARK BLUE SHIELD | 
| 57346 | Other | PA | AETNA | 
| CF4471 | Other | PA | RAILROAD MEDICARE | 
| 0053194000 | Other | PA | M SHAYEGAN MD | 
| 2740362000 | Other | PA | IBC | 
| 0053171000 | Other | PA | KEYSTONE | 
| 180010359 | Other | PA | RAILROAD MEDICARE | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 152W00000X | Optometrist | OE005574 (Pennsylvania) | Secondary | 
| 332H00000X | Eyewear Supplier | (Pennsylvania) | Secondary | 
| 207W00000X | Ophthalmology | (Pennsylvania) | Primary | 
| Provider Name | Benjamin Alan Kauffman | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1245265578 PECOS PAC ID: 9335143874 Enrollment ID: I20060914000225 | 
| Provider Name | Michael J Sponberg | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1578532826 PECOS PAC ID: 4587858618 Enrollment ID: I20101102000831 | 
| Provider Name | Dennis J Khoury | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1942269048 PECOS PAC ID: 8527057728 Enrollment ID: I20110601000501 | 
| Provider Name | Mustapha Shayegan | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1780653139 PECOS PAC ID: 5890784094 Enrollment ID: I20110607000404 | 
| Provider Name | Felina Z Kremer | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1871852376 PECOS PAC ID: 2567750581 Enrollment ID: I20170630000504 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Eye Surgical Medical Associates Pc 8118 Bustleton Ave, Phila, PA 19152 Ph: (215) 342-8118 | Eye Surgical Medical Associates Pc 8118 Bustleton Ave, Phila, PA 19152-2803 Ph: (215) 342-8118 |