Joy Marie Ellerbrock-Heitzman, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

5716/T2630 Issued in OH

Practice address

301 E State Route 613
Continental, OH 45831-9133

Phone

(419) 596-3062

NPI assigned

Aug 17, 2007

Last updated

Oct 5, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Ohio State University - College of Optometry, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Modern Eyecare LLCGroup PAC ID 3779630355, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Modern Eyecare LLC

  • Optometrist
  • Continental, OH
  • NPI 1245476191
  Medicare reassignment Care Compare group NPD
• Mid Michigan Eye Care Center, PC

  dba Specialty Eye Institute

  • Ophthalmology Physician
  • Jackson, MI
  • NPI 1649275041

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1134311764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42",
            "city": "CONTINENTAL",
            "state": "OH",
            "postal_code": "458310042",
            "telephone_number": "419-596-3062",
            "fax_number": "419-596-3064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E STATE ROUTE 613",
            "city": "CONTINENTAL",
            "state": "OH",
            "postal_code": "458319133",
            "telephone_number": "419-596-3062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLERBROCK-HEITZMAN",
        "first_name": "JOY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-17",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5716/T2630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Continental Local Schools
• Ashleigh Marie Doster, LPN
• Fauster Cameron Inc., Dba Defiance Clinic
• Larry David Heiing, RPH
• Carley Hermiller
• Stacie Hicks, D.O.
• Hicksfamilymedicineohio, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.