NPIMap

Individual provider Active NPI

Stephen Carl Sulyi, OD

  • Optometrist
  • Chardon, OH
National Provider Identifier
1073609913
Registry record updated Dec 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6524 Issued in OH
Practice address
118 Chimney RDG
Chardon, OH 44024-4006
Phone
(864) 884-7432
Fax
(864) 688-2307
NPI assigned
Oct 5, 2006
Last updated
Dec 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6524 OH Primary
Optometrist 152W00000X OPT002332 GA
Optometrist 152W00000X 1437 SC

Addresses

Primary practice location

118 Chimney RDG
Chardon, OH 44024-4006

Mailing address

118 Chimney RDG
Chardon, OH 44024-4006
Phone (864) 884-7432

Other identifiers 1

IdentifierTypeStateIssuer
0212124MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6524OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
1 Hour Optical P C Optometrist Past Accepting new patients
Stephen C Sulyi, O.D., LLC Past Accepting new patients
Macmillan Optical, Inc Single Specialty PastSince Jan 1, 2006 Accepting new patients
Eye Care Associates of SC LLC Optometrist Past Accepting new patients

Organizations & group practices 7

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1073609913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 CHIMNEY RDG",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440244006",
            "telephone_number": "864-884-7432",
            "fax_number": "864-688-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 CHIMNEY RDG",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440244006",
            "telephone_number": "864-884-7432",
            "fax_number": "864-688-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULYI",
        "first_name": "STEPHEN",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6524",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002332",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1437",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0212124",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chardon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2018; 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.