NPIMap

Organization Active NPI

Eye Care Associates, Inc

  • Ophthalmology Physician
  • Warren, OH
National Provider Identifier
1245315068
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYE CARE ASSOCIATES, INC
Practice address
4060 N River Rd NE
Warren, OH 44484-1039
Phone
(330) 746-7691
Fax
(330) 743-8368
NPI assigned
Oct 27, 2006
Last updated
Jan 6, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
EYE CARE ASSOCIATES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Authorized official

Name
Kayla R Wolsiefer
Title
Credentialing Specialist
Phone
(330) 884-6584

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

4060 N River Rd NE
Warren, OH 44484-1039

Mailing address

10 Dutton Dr
Youngstown, OH 44502-1818
Phone (330) 884-6584

Other identifiers 1

IdentifierTypeStateIssuer
2858653MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091222000146 OH Part B Supplier - Clinic/Group Practice 0042350118 Receives reassigned benefits from 17 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Youngstown, OH; East Liverpool, OH; Warren, OH; Austintown, OH; Poland, OH

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Robert J Gerberry7 organizations share this tax ID, including this one
Part of
Robert J Gerberry

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736121600000",
    "number": "1245315068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DUTTON DR",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445021818",
            "telephone_number": "330-884-6584",
            "fax_number": "330-743-8368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 N RIVER RD NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444841039",
            "telephone_number": "330-746-7691",
            "fax_number": "330-743-8368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE ASSOCIATES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYE CARE ASSOCIATES, INC",
        "enumeration_date": "2006-10-27",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A",
        "authorized_official_last_name": "WOLSIEFER",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "330-884-6584"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2858653",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.