Organization Active NPI

Eye Care of McConnelsville LLC

  • Optometrist
  • McConnelsville, OH
National Provider Identifier
1225115058
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYE CARE OF MCCONNELSVILLE LLC
Practice address
71 E Main St
McConnelsville, OH 43756-1180
Phone
(740) 962-4281
Fax
(740) 962-5741
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Authorized official

Name
Dr. Mark M Ruff, O.D.NPI 1831120096
Title
Owner
Phone
(740) 962-4281

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

71 E Main St
McConnelsville, OH 43756-1180

Mailing address

71 E Main St
McConnelsville, OH 43756-1180
Phone (740) 962-4281

Other identifiers 1

IdentifierTypeStateIssuer
0854295MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100430000064 OH Part B Supplier - Clinic/Group Practice 3072640630 Receives reassigned benefits from 6 practitioners
Practice locations: McConnelsville, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625702400000",
    "number": "1225115058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 E MAIN ST",
            "city": "MCCONNELSVILLE",
            "state": "OH",
            "postal_code": "437561180",
            "telephone_number": "740-962-4281",
            "fax_number": "740-962-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 E MAIN ST",
            "city": "MCCONNELSVILLE",
            "state": "OH",
            "postal_code": "437561180",
            "telephone_number": "740-962-4281",
            "fax_number": "740-962-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE OF MCCONNELSVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A",
        "authorized_official_last_name": "RUFF",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-962-4281",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0854295",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McConnelsville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.