Dennis R Laub, O.D.
Individual provider Active NPI Optometrist · Woodville, OH
NPI 1124197868 · NPPES record last updated Dec 7, 2016
Key facts
- NPI
- 1124197868
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 3075T937 (OH)
- Practice address
- 107 S Walnut St
Woodville, OH 43469-1333 - Phone
- (419) 849-3811
- Fax
- (419) 849-3374
- NPI assigned
- Nov 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100825000191 | OH | Practitioner - Optometry | 0244354454 | Practice locations: Oak Harbor, OH; Woodville, OH |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kyle a. Brodie, O.D., Inc. | Optometrist | Past |
Accepting new patients |
| Optometric Management Group LLC | Optometrist | Past | Accepting new patients |
| William Kegerize OD LLC | Past | Accepting new patients |
Interoperability endpoints
- dennis.laub@direct.revolutionehr.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3075T937 | OH | Yes |
Addresses
Primary practice location
107 S Walnut St
Woodville, OH 43469-1333
Mailing address
107 S Walnut St
Woodville, OH 43469-1333
Phone (419) 849-3811
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0303399 | Medicaid | OH |
Other names
- Dr. Dennis R Laub
Other providers in Woodville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.