Individual provider Active NPI

Melissa Marie Bennett, O.D.

  • Optometrist
  • Chillicothe, OH
National Provider Identifier
1003063504
Registry record updated Jul 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5787 Issued in OH
Practice address
17273 State Route 104
Chillicothe, OH 45601-9718
Phone
(740) 773-1141
NPI assigned
Aug 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5787 OH Primary

Addresses

Primary practice location

17273 State Route 104
Chillicothe, OH 45601-9718

Mailing address

5662 Platinum Dr
Grove City, OH 43123-8271
Phone (740) 579-1235

Other names 1

  • Melissa Marie Degasperis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140618001647 OH Practitioner - Optometry 1951525765 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harris Opticians Inc 3 clinicians

Practice addresses (Care Compare)

2869 N High St
Columbus, OH 43202-1101
Phone (614) 263-2020

3725 N High St
Columbus, OH 43214-3524
Phone (614) 261-8155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5787OHMDPsychologist

Practice roles (2 of 4)

OrganizationSpecialtyStatusNew patients
Harris Opticians, Inc Optometrist CurrentSince Dec 1, 2015 Accepting new patients
Eoy,LLC Past Accepting new patients

Locations

3725 N High St
Columbus, OH 43214
Phone (614) 261-8155

Networks

  • OH PPO
  • devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JCABDD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373587200000",
    "number": "1003063504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5662 PLATINUM DR",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "431238271",
            "telephone_number": "740-579-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17273 STATE ROUTE 104",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456019718",
            "telephone_number": "740-773-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-26",
        "last_updated": "2013-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "DEGASPERIS",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chillicothe, OH

Sources for this page

Verify at the official NPI Registry.