Active NPI
Sara Bokan Ciccotelli, O.D.
- Optometrist
- Columbus, OH
National Provider Identifier
1205218294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT 6356
- Practice address
- 420 N James Rd
Columbus, OH 43219-1834 - Phone
- (614) 257-5642
- NPI assigned
- Jun 25, 2015
- Sex
- Female
- 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 | OPT 6356 | OH | Primary |
Addresses
Primary practice location
420 N James Rd
Columbus, OH 43219-1834
Mailing address
3632 Lacey Woods Park
Hilliard, OH 43026-8922
Phone (330) 717-7996
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT 6356 | OH | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652400000000",
"number": "1205218294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3632 LACEY WOODS PARK",
"city": "HILLIARD",
"state": "OH",
"postal_code": "430268922",
"telephone_number": "330-717-7996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 N JAMES RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432191834",
"telephone_number": "614-257-5642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CICCOTELLI",
"first_name": "SARA",
"middle_name": "BOKAN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-25",
"last_updated": "2022-05-13",
"certification_date": "2022-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "OPT 6356",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.