Individual provider Active NPI

Elizabeth Jean Cockerill, OD

  • Optometrist
  • Columbus, OH
National Provider Identifier
1124259064
Registry record updated Apr 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.005853 Issued in OH
Practice address
5141 W Broad St Ste 100
Columbus, OH 43228-1992
Phone
(614) 878-1571
NPI assigned
Jul 27, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2020

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.005853 OH Primary

Addresses

Primary practice location

5141 W Broad St Ste 100
Columbus, OH 43228-1992

Mailing address

5141 W Broad St Ste 100
Columbus, OH 43228-1992
Phone (614) 878-1571

Other practice location 1

4830 Knightsbridge Blvd Ste G
Columbus, OH 43214-2300
Phone (614) 488-8000

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
I20100708000641 OH Practitioner - Optometry 6507997566 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid Ohio Ophthalmic Consultants, LTDGroup PAC ID 8022042415, 5 clinicians
Complete Eyecare West IncGroup PAC ID 2769416569, 2 clinicians

Practice addresses (Care Compare)

4830 Knightsbridge Blvd
Suite G
Columbus, OH 43214-2300
Phone (614) 488-8000

5141 W Broad St
Suite 100
Columbus, OH 43228-1992
Phone (614) 878-1571

Merit-based Incentive Payment System (MIPS)

Final score
74.35 of 100Reported as group
Quality
100
Improvement activities
40
Cost
14.52

Merit-based Incentive Payment System (MIPS)

Final score
90.07 of 100Reported as group
Quality
94.4
Improvement activities
40
Cost
74.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.005853OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Physicians, LLC Optometrist CurrentSince Dec 1, 2020 Accepting new patients
Eye Physicians, LLC CurrentSince Dec 1, 2020 Accepting new patients
Mid Ohio Ophthalmic Consultants, LTD Past Accepting new patients

Locations

4830 Knightsbridge Blvd
Ste G
Columbus, OH 43214
Phone (614) 488-8000

2929 Kenny Rd
Ste 150
Columbus, OH 43221
Phone (614) 488-8000

855 W Market St
Lima, OH 45805
Phone (419) 228-7432

885 N Sandusky Ave
Upper Sandusky, OH 43351
Phone (419) 294-4991

Organizations & group practices 6

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": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586563200000",
    "number": "1124259064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5141 W BROAD ST STE 100",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281992",
            "telephone_number": "614-878-1571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5141 W BROAD ST STE 100",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281992",
            "telephone_number": "614-878-1571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4830 Knightsbridge Blvd Ste G",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432142300",
            "country_code": "US",
            "telephone_number": "614-488-8000",
            "fax_number": "614-488-8610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COCKERILL",
        "first_name": "ELIZABETH",
        "middle_name": "JEAN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-27",
        "last_updated": "2020-04-11",
        "certification_date": "2020-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.005853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.