Active NPI
William George Bartolovich, O.D.
- Optometrist
- Youngstown, OH
National Provider Identifier
1184607137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 152WOOOOOX
- Practice address
- 10 Dutton Dr
Youngstown, OH 44502-1818 - Phone
- (330) 746-7691
- Fax
- (330) 743-8322
- NPI assigned
- Nov 23, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 152WOOOOOX | OH | Primary |
Addresses
Primary practice location
10 Dutton Dr
Youngstown, OH 44502-1818
Mailing address
10 Dutton Dr
Youngstown, OH 44502-1818
Phone (330) 746-7691
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110304 | Other | OH | EYEMED |
| 0489636 | Medicaid | OH | |
| 580031358 | Other | OH | RAILROAD MEDICARE |
| 2683 | Other | OH | VBA |
| 34110468300 | Other | OH | WORKERS COMPENSATION |
| 360199 | Other | OH | NVA |
| 73876 | Other | OH | CLARITY |
| 2290061 | Other | OH | UNITED HEALTHCARE |
| 73876 | Other | OH | MOUNTAIN STATE |
| 000000127326 | Other | OH | BLUE CROSS |
| 009026 | Other | OH | CHAMPUS |
| 4405115 | Other | OH | AETNA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 152WOOOOOX | OH | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454976000000",
"number": "1184607137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 DUTTON DR",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445021818",
"telephone_number": "330-746-7691",
"fax_number": "330-743-8322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 DUTTON DR",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445021818",
"telephone_number": "330-746-7691",
"fax_number": "330-743-8322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARTOLOVICH",
"first_name": "WILLIAM",
"middle_name": "GEORGE",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-23",
"last_updated": "2016-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "152WOOOOOX",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYEMED",
"identifier": "110304",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0489636",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "580031358",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VBA",
"identifier": "2683",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKERS COMPENSATION",
"identifier": "34110468300",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NVA",
"identifier": "360199",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLARITY",
"identifier": "73876",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "2290061",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOUNTAIN STATE",
"identifier": "73876",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "000000127326",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "009026",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4405115",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.