Nicholas Tyler Perichak, O.D, M.S.

Primary specialty

OptometristTaxonomy code 152W00000X

License

6400 Issued in OH

Practice address

1010 N 21St St
Newark, OH 43055-2984

Phone

(740) 366-5050

NPI assigned

Jun 11, 2015

Last updated

Jun 11, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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.

• Newark Family Eye Care LLC

  • Optometrist
  • Newark, OH
  • NPI 1760999882
  Authorized official Same address or phone

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1053792424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N 21ST ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430552984",
            "telephone_number": "740-366-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N 21ST ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430552984",
            "telephone_number": "740-366-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERICHAK",
        "first_name": "NICHOLAS",
        "middle_name": "TYLER",
        "credential": "O.D, M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-11",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paris Pelletier
• Hannah Elizabeth Pellett, CNP
• Katelyn Ann Pennington
• Amy Beth Penrose, LPN
• Charles Penvose, DPM
• Sydney Perkins
• Katheryn Perse
• Peggy Sue Pesimer
• Emily Pessel
• Michele Peterman

• Optometrist in Newark, OH
• Providers in Newark, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.