Individual provider Active NPI

Carol Ann Miske, O.D.

  • Optometrist
  • North Ridgeville, OH
National Provider Identifier
1225096696
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3430 Issued in OH
Practice address
7079 Avon Belden Rd
North Ridgeville, OH 44039-3774
Phone
(440) 327-2020
Fax
(440) 327-5174
NPI assigned
May 3, 2006
Last updated
Jan 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3430 OH Primary

Addresses

Primary practice location

7079 Avon Belden Rd
North Ridgeville, OH 44039-3774

Mailing address

7079 Avon Belden Rd
North Ridgeville, OH 44039-3774
Phone (440) 327-2020

Other names 1

  • Dr. Carol Ann Novak Professional name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110406000400 OH Practitioner - Optometry 5890827877

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Avon Eye Design, Inc. Optometrist CurrentSince Aug 2, 2022 Accepting new patients

Locations

7079 Avon Belden Rd
North Ridgeville, OH 44039
Phone (440) 327-2020

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, 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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1225096696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7079 AVON BELDEN RD",
            "city": "NORTH RIDGEVILLE",
            "state": "OH",
            "postal_code": "440393774",
            "telephone_number": "440-327-2020",
            "fax_number": "440-327-5174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7079 AVON BELDEN RD",
            "city": "NORTH RIDGEVILLE",
            "state": "OH",
            "postal_code": "440393774",
            "telephone_number": "440-327-2020",
            "fax_number": "440-327-5174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISKE",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "NOVAK",
            "middle_name": "ANN",
            "prefix": "DR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in North Ridgeville, OH

Sources for this page

Verify at the official NPI Registry.