Modern Eyecare LLC
Organization Active NPI Optometrist · Continental, OH
NPI 1245476191 · NPPES record last updated Oct 5, 2022
Key facts
- NPI
- 1245476191
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- MODERN EYECARE LLC
- Practice address
- 301 E State Route 613
Continental, OH 45831-9133 - Phone
- (419) 596-3062
- NPI assigned
- Dec 24, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Joy M Ellerbrock, O.D.
- Title
- Owner
- Phone
- (419) 615-3802
Practitioners 2
-
Whitney Spitnale, OD
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Modern Eyecare LLC |
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090416000720 | OH | Part B Supplier - Clinic/Group Practice | 3779630355 |
Receives reassigned benefits from 2 practitioners Practice locations: Continental, OH |
| O20100930032383 | OH | DME Supplier - Physician - Optometrist | 3779630355 | Practice locations: Continental, OH |
National Provider Directory
Locations
301 E State Route 613
Continental, OH 45831
Phone (419) 596-3062
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
301 E State Route 613
Continental, OH 45831-9133
Mailing address
PO Box 42
Continental, OH 45831-0042
Phone (419) 596-3062
Other providers in Continental, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.