Individual provider Active NPI

Donald Grutzmacher, O.D.

  • Optometrist
  • Cincinnati, OH
National Provider Identifier
1043380249
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3173T465 Issued in OH
Practice address
486 Ohio Pike
Cincinnati, OH 45255-3343
Phone
(513) 753-8225
Fax
(513) 753-8589
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

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 3173T465 OH Primary

Addresses

Primary practice location

486 Ohio Pike
Cincinnati, OH 45255-3343

Mailing address

486 Ohio Pike
Cincinnati, OH 45255-3343
Phone (513) 753-8225

Other identifiers 1

IdentifierTypeStateIssuer
0345693MedicaidOH

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
I20100326000865 OH Practitioner - Optometry 4284525171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cooke Landen and Grutzmacher OD IncGroup PAC ID 3577555614, 4 clinicians

Practice addresses (Care Compare)

486 Ohio Pike
Cincinnati, OH 45255-3343
Phone (513) 753-8225

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3173T465OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Cooke Landen & Grutzmacher OD Inc Optometrist CurrentSince Jan 1, 1987 Accepting new patients

Locations

486 Ohio Pike
Cincinnati, OH 45255
Phone (513) 528-8601

Organizations & group practices 1

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043380249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "486 OHIO PIKE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452553343",
            "telephone_number": "513-753-8225",
            "fax_number": "513-753-8589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "486 OHIO PIKE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452553343",
            "telephone_number": "513-753-8225",
            "fax_number": "513-753-8589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUTZMACHER",
        "first_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3173T465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0345693",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.