Individual provider Active NPI

Robert J Dittoe, O.D.

  • Optometrist
  • New Lexington, OH
National Provider Identifier
1184671174
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3465/T409 Issued in OH
Practice address
391 Lincoln Park Dr
New Lexington, OH 43764-1080
Phone
(740) 342-1784
Fax
(740) 342-1791
NPI assigned
May 27, 2006
Last updated
Nov 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3465/T409 OH Primary

Addresses

Primary practice location

391 Lincoln Park Dr
New Lexington, OH 43764-1080

Mailing address

449 Buckingham LN
Lancaster, OH 43130-8891
Phone (740) 681-9680

Other identifiers 2

IdentifierTypeStateIssuer
580002099AOtherOHRAILROAD MEDICARE
0429656MedicaidOH

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

LicenseStateTypeSpecialty
3465/T409OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Medical Inc Optometrist Current Accepting new patients

Locations

3255 Levis Commons Blvd
Perrysburg, OH 43551
Phone (419) 874-0393

740 Commerce Dr
Ste A
Perrysburg, OH 43551
Phone 24852821166

Interoperability endpoints

  • Direct secure messaging: rdittoe@direct.revolutionehr.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1184671174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "449 BUCKINGHAM LN",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431308891",
            "telephone_number": "740-681-9680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 LINCOLN PARK DR",
            "city": "NEW LEXINGTON",
            "state": "OH",
            "postal_code": "437641080",
            "telephone_number": "740-342-1784",
            "fax_number": "740-342-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTOE",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3465/T409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "580002099A",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0429656",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lexington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; 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.