NPIMap

Individual provider Active NPI

Anna Maria Louise Ellsesser, O.D.

  • Optometrist
  • Westlake, OH
National Provider Identifier
1124104690
Registry record updated Feb 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5569/T2483 Issued in OH
Practice address
30588 Center Ridge Rd
Westlake, OH 44145
Phone
(440) 892-5367
Fax
(440) 249-5094
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5569 OH
Optometrist 152W00000X 1657T KY
Optometrist 152W00000X 5569/T2483 OH Primary

Addresses

Primary practice location

30588 Center Ridge Rd
Westlake, OH 44145

Mailing address

30588 Center Ridge Rd
Westlake, OH 44145
Phone (440) 892-5367

Other identifiers 1

IdentifierTypeStateIssuer
3016711MedicaidOH

Other names 1

  • Dr. Anna Maria Louise Ruggles Former name

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
1657TKYMDOptometrist
5569OHMDOptometrist
5569/T2483OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Anna C. Hopkins & Associates Optometrist Past Accepting new patients
Aeg Texas Professional PLLC Optometrist Past Accepting new patients
Wing Eyecare, Inc. Optometrist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328227200000",
    "number": "1124104690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30588 CENTER RIDGE RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "44145",
            "telephone_number": "440-892-5367",
            "fax_number": "440-249-5094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30588 CENTER RIDGE RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "44145",
            "telephone_number": "440-892-5367",
            "fax_number": "440-249-5094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLSESSER",
        "first_name": "ANNA",
        "middle_name": "MARIA LOUISE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2012-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5569",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1657T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5569/T2483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3016711",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "RUGGLES",
            "middle_name": "MARIA LOUISE",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Westlake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2012; 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.