Individual provider Active NPI

Peter V. Mogyordy, O.D.

  • Optometrist
  • Westlake, OH
National Provider Identifier
1043203078
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4481 Issued in OH
Practice address
26927 Detroit Rd
Westlake, OH 44145-2370
Phone
(440) 892-5367
Fax
(440) 249-5094
NPI assigned
Aug 24, 2005
Last updated
Jun 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4481 OH Primary
Corneal and Contact Management Optometrist 152WC0802X 4481 OH
Pediatric Optometrist 152WP0200X 4481 OH
Occupational Vision Optometrist 152WX0102X 4481 OH

Addresses

Primary practice location

26927 Detroit Rd
Westlake, OH 44145-2370

Mailing address

26927 Detroit Rd
Westlake, OH 44145-2370
Phone (440) 892-5367

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
I20080609000841 OH Practitioner - Optometry 3173413283 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Madison Eye Care Associates IncGroup PAC ID 9234123084, 7 clinicians

Practice addresses (Care Compare)

17520 Madison Ave
Lakewood, OH 44107-3535
Phone (216) 228-3343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Vision Center II LLC Optometrist CurrentSince Jul 1, 2010 Accepting new patients
Madison Eye Care Associates Inc Optometrist CurrentSince Sep 15, 1993 Accepting new patients
Madison Eye Care of Port Clinton LLC Optometrist CurrentSince Aug 1, 2023 Accepting new patients
Sue E. Van Dootingh OD Past Accepting new patients

Locations

17520 Madison Ave
Lakewood, OH 44107
Phone (216) 228-3343

6204 Brookpark Rd
Parma, OH 44129
Phone (216) 351-6270

6390 Pearl Rd
Parma Heights, OH 44130
Phone (216) 291-3550

820 Jefferson St
Port Clinton, OH 43452
Phone (419) 732-2828

26927 Detroit Rd
Westlake, OH 44145
Phone (440) 892-5367

30588 Center Ridge Rd
Westlake, OH 44145
Phone (440) 892-5367

Interoperability endpoints

  • Direct secure messaging: drpete@madison-eye-care-assoc.direct.kno2fy.com

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1043203078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26927 DETROIT RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441452370",
            "telephone_number": "440-892-5367",
            "fax_number": "440-249-5094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26927 DETROIT RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441452370",
            "telephone_number": "440-892-5367",
            "fax_number": "440-249-5094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGYORDY",
        "first_name": "PETER",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4481",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OH",
            "license": "4481",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "OH",
            "license": "4481",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "OH",
            "license": "4481",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

Verify at the official NPI Registry.