Active NPI
Melissa Marie Bennett, O.D.
- Optometrist
- Chillicothe, OH
National Provider Identifier
1003063504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5787
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5787 | OH | MD | Psychologist |
Practice roles (2 of 4)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harris Opticians, Inc | Optometrist | Current | 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
- 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.
-
- Corneal and Contact Management Optometrist
- Columbus, OH
- NPI 1063405405
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.