Individual provider Active NPI

Amy Dawn Titus, O.D.

  • Optometrist
  • Wickliffe, OH
National Provider Identifier
1073621264
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5246 Issued in OH
Practice address
29610 Euclid Ave
Wickliffe, OH 44092-1829
Phone
(440) 943-1993
Fax
(440) 943-9595
NPI assigned
Aug 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 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 5246 OH Primary

Addresses

Primary practice location

29610 Euclid Ave
Wickliffe, OH 44092-1829

Mailing address

29610 Euclid Ave
Wickliffe, OH 44092-1829
Phone (440) 943-1993

Other identifiers 3

IdentifierTypeStateIssuer
2327986MedicaidOH
341194090027OtherOHCARE SOURCE
000000238954OtherOHANTHEM

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
I20101013000154 OH Practitioner - Optometry 0749472488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sid Savitt IncGroup PAC ID 9436431087, 3 clinicians

Practice addresses (Care Compare)

29610 Euclid Ave
Wickliffe, OH 44092-1829
Phone (440) 943-1993

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5246OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sid Savitt, Inc. Optometrist CurrentSince Jan 1, 2017 Accepting new patients
Ellen L. Ellsworth, OD Inc Optometrist PastSince Apr 1, 2002 Accepting new patients
Shawna L Franey, OD, Inc Optometrist PastSince Jan 20, 2010 Accepting new patients
Sid Savitt, Optometrist, Inc. Optometrist Past Accepting new patients

Locations

29610 Euclid Ave
Wickliffe, OH 44092
Phone (440) 943-1993

Organizations & group practices 4

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1073621264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29610 EUCLID AVE",
            "city": "WICKLIFFE",
            "state": "OH",
            "postal_code": "440921829",
            "telephone_number": "440-943-1993",
            "fax_number": "440-943-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29610 EUCLID AVE",
            "city": "WICKLIFFE",
            "state": "OH",
            "postal_code": "440921829",
            "telephone_number": "440-943-1993",
            "fax_number": "440-943-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TITUS",
        "first_name": "AMY",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2327986",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE SOURCE",
            "identifier": "341194090027",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000238954",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wickliffe, OH

Sources for this page

Verify at the official NPI Registry.