Individual provider Active NPI

Emmett Cleary, O.D.

  • Optometrist
  • Port Clinton, OH
National Provider Identifier
1023027646
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5356 T2264 Issued in OH
Practice address
2826 E Harbor Rd
Port Clinton, OH 43452-2611
Phone
(419) 734-7995
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5356 T2264 OH Primary

Addresses

Primary practice location

2826 E Harbor Rd
Port Clinton, OH 43452-2611

Mailing address

4651 Quincy Adams Court
Lorain, OH 44053
Phone (440) 960-7434

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
I20150317002475 OH Practitioner - Optometry 2961729678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobile Medical IncGroup PAC ID 5890765481, 80 clinicians

Practice addresses (Care Compare)

3255 Levis Commons Blvd
Perrysburg, OH 43551-7145
Phone (419) 874-0393

Merit-based Incentive Payment System (MIPS)

Final score
93.57 of 100Reported as group
Quality
58.53
Promoting interoperability
100
Improvement activities
40
Cost
86.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5356 T2264OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Medical Inc Optometrist CurrentSince Apr 20, 2016 Accepting new patients
Mobile Medical, Inc. CurrentSince Apr 20, 2016 Accepting new patients
Mobile Medical, Inc. Past Accepting new patients

Locations

3255 Levis Commons Blvd
Perrysburg, OH 43551
Phone (419) 874-0393

740 Commerce Dr
Ste A
Perrysburg, OH 43551
Phone 24852821166

Interoperability endpoints

  • Direct secure messaging: emmett.cleary.p19@direct.360care.nextgenshare.com

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023027646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 QUINCY ADAMS COURT",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "44053",
            "telephone_number": "440-960-7434",
            "fax_number": "440-960-7434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2826 E HARBOR RD",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434522611",
            "telephone_number": "419-734-7995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEARY",
        "first_name": "EMMETT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5356 T2264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Clinton, OH

Sources for this page

Verify at the official NPI Registry.