Individual provider Active NPI

Jeffrey Durkin, OD

  • Optometrist
  • Akron, OH
National Provider Identifier
1245213610
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3937 Issued in OH
Practice address
1655 W Market St
Akron, OH 44313-7004
Phone
(330) 867-1104
Fax
(330) 867-1615
NPI assigned
Nov 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T764 OH
Optometrist 152W00000X 3937 OH Primary

Addresses

Primary practice location

1655 W Market St
Akron, OH 44313-7004

Mailing address

1655 W Market St
Akron, OH 44313-7004
Phone (330) 867-1104

Other identifiers 1

IdentifierTypeStateIssuer
000000136876OtherANTHEM BCBS

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
I20090423000594 OH Practitioner - Optometry 6507914975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Ohio Professional PCGroup PAC ID 7618207036, 80 clinicians

Practice addresses (Care Compare)

1655 W Market St
Suite 110
Akron, OH 44313-7030
Phone (330) 867-1104

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3937OHMDCounseling Psychologist
T764OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Ohio Professional PC Optometrist CurrentSince Oct 20, 2021 Accepting new patients
Aeg Ohio Professional PC Optometrist CurrentSince Oct 20, 2021 Accepting new patients
Thomas M Grischow OD Inc Optometrist Past Accepting new patients
Thomas M. Grischow, O.D., Inc. Optometrist Past Accepting new patients

Locations

1655 W Market St
Ste 110
Akron, OH 44313
Phone (330) 867-1104

33541 Aurora Rd
Solon, OH 44139
Phone (440) 248-2020

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1245213610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 W MARKET ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443137004",
            "telephone_number": "330-867-1104",
            "fax_number": "330-867-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 W MARKET ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443137004",
            "telephone_number": "330-867-1104",
            "fax_number": "330-867-1615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURKIN",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "T764",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000136876",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.