Individual provider Active NPI

Bradley Ortisi, OD

  • Optometrist
  • Zanesville, OH
National Provider Identifier
1114619426
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.007149 Issued in OH
Practice address
2315 Maple Ave
Zanesville, OH 43701-2028
Phone
(740) 453-1611
Fax
(740) 450-7680
NPI assigned
May 24, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.007149 OH Primary

Addresses

Primary practice location

2315 Maple Ave
Zanesville, OH 43701-2028

Mailing address

2315 Maple Ave
Zanesville, OH 43701-2028
Phone (740) 453-1611

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
I20230926004400 OH Practitioner - Optometry 8729432638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Ohio Professional PCGroup PAC ID 7618207036, 80 clinicians

Practice addresses (Care Compare)

6472 Winchester Blvd
Canal Winchester, OH 43110-2004
Phone (614) 837-9595

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.007149OHMDOptometrist
7419OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Ohio Professional PC Optometrist CurrentSince Oct 21, 2024 Accepting new patients
Aeg Ohio Professional PC Optometrist CurrentSince Oct 21, 2024 Accepting new patients
Robert J. Dittoe, O.D., Inc. Optometrist Past Accepting new patients

Locations

6472 Winchester Blvd
Canal Wnchstr, OH 43110
Phone (614) 837-9595

9755 Fairway Dr
Powell, OH 43065
Phone (614) 336-2020

33541 Aurora Rd
Solon, OH 44139
Phone (440) 248-2020

888 E Court St
Urbana, OH 43078
Phone (937) 652-1144

Organizations & group practices 3

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": "1684886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1114619426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 MAPLE AVE",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437012028",
            "telephone_number": "740-453-1611",
            "fax_number": "740-450-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 MAPLE AVE",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437012028",
            "telephone_number": "740-453-1611",
            "fax_number": "740-450-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTISI",
        "first_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.007149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zanesville, OH

Sources for this page

Verify at the official NPI Registry.