Kenneth Andrew Boyle Sr., OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2758 Issued in OH

Practice address

7875 Johnny Cake Ridge Rd
Great Lakes Mall
Mentor, OH 44060-5529

Phone

(440) 255-2176

Fax

(440) 255-1094

NPI assigned

May 10, 2006

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

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.

• SVS Vision Inc

  dba SVS Vision Optical Centers

  • Optometrist
  • Fairlawn, OH
  • NPI 1902395510
  Medicare reassignment NPD
• SVS Vision Inc

  dba SVS Vision Optical Centers

  • Optometrist
  • Mentor, OH
  • NPI 1346746229
  NPD

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1184673576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7875 JOHNNY CAKE RIDGE RD",
            "address_2": "GREAT LAKES MALL",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440605529",
            "telephone_number": "440-255-2176",
            "fax_number": "440-255-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7875 JOHNNY CAKE RIDGE RD",
            "address_2": "GREAT LAKES MALL",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440605529",
            "telephone_number": "440-255-2176",
            "fax_number": "440-255-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLE",
        "first_name": "KENNETH",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "2758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0002124",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Payton Boyd
• Sarah E Boyda, RN
• Logan Boyer
• Dorreta Boykin, MSSA, LISW
• Patrick T Boylan, MD
• James Matthew Bozic, O.D.
• Laura B Bracknell, DO
• Courtney Bradac
• Barry Rex Bradford, D.C.
• Bradley Johnson D.M.D., M.S.D., LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.