Great Lakes Eyecare, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

5461 Issued in OH

Legal business name

GREAT LAKES EYECARE, LLC

Practice address

7348 Mentor Ave
Mentor, OH 44060-7543

Phone

(440) 953-2020

Fax

(440) 953-2030

NPI assigned

Feb 6, 2007

Last updated

Sep 14, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James Matthew Bozic, O.D.NPI 1295874048

Title

President

Phone

(440) 953-2020

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James Matthew Bozic, O.D.

  • Optometrist
  • Mentor, OH
  • NPI 1295874048
  Authorized official Same address or phone
• Jenna Bayer, OD

  • Optometrist
  • Mentor, OH
  • NPI 1942022611
  NPD (past)
• Chelsea Des Rosiers, O.D.

  • Optometrist
  • Westlake, OH
  • NPI 1417622994
  NPD (past)

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189728000000",
    "number": "1124167978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7348 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440607543",
            "telephone_number": "440-953-2020",
            "fax_number": "440-953-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7348 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440607543",
            "telephone_number": "440-953-2020",
            "fax_number": "440-953-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES EYECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-09-14",
        "status": "A",
        "authorized_official_last_name": "BOZIC",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-953-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Marie Gray, LPCC
• Jessica Graziano, LISW-S
• Bruce Daniel Grbach, D.D.S.
• Great Lake Dental Arts
• Great Lakes Ambulatory Surgery Center
• Great Lakes Gastroenterology Research
• Great Lakes Home Health Ohio 2, LLC (Elara Caring)
• Great Lakes Pharmacy
• Jennifer L Grebenc, RDN LD
• Victor Steven Greco, D.D.S.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2007; 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.