Individual provider Active NPI

Susan Ross, O.D.

  • Optometrist
  • Lakewood, OH
National Provider Identifier
1013051358
Registry record updated Apr 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3491 T1509 Issued in OH
Practice address
18216 Sloane Ave
Lakewood, OH 44107-3110
Phone
(216) 521-2020
Fax
(216) 521-6088
NPI assigned
Feb 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3491 T1509 OH Primary

Addresses

Primary practice location

18216 Sloane Ave
Lakewood, OH 44107-3110

Mailing address

29665 Cedar Rd
Mayfield Heights, OH 44124-4411
Phone (216) 521-2020

Other names 1

  • Dr. Susan Diana Guzick-Ross Other 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
I20100513000028 OH Practitioner - Optometry 7810025830 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3491 T1509OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Ohio Professional PC Optometrist CurrentSince Sep 7, 2019 Accepting new patients
Aeg Ohio Professional PC Optometrist CurrentSince Sep 7, 2019 Accepting new patients

Locations

33541 Aurora Rd
Solon, OH 44139
Phone (440) 248-2020

28699 Chagrin Blvd
Ste 400
Woodmere, OH 44122
Phone (216) 514-3002

Networks

  • OH PPO
  • devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
  • devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
  • devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9
  • KY PPO
  • devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8
  • KY PPO C-SNP

Organizations & group practices 2

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": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271721600000",
    "number": "1013051358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29665 CEDAR RD",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441244411",
            "telephone_number": "216-521-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18216 SLOANE AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441073110",
            "telephone_number": "216-521-2020",
            "fax_number": "216-521-6088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2010-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3491  T1509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "GUZICK-ROSS",
            "middle_name": "DIANA",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lakewood, OH

Sources for this page

Verify at the official NPI Registry.