Individual provider Active NPI

Sophia Fotinos, O.D.

  • Optometrist
  • Sandusky, OH
National Provider Identifier
1316385362
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6197 Issued in OH
Practice address
905 Crossings Rd
Sandusky, OH 44870-8913
Phone
(419) 626-5148
NPI assigned
Jun 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6197 OH Primary

Addresses

Primary practice location

905 Crossings Rd
Sandusky, OH 44870-8913

Mailing address

905 Crossings Rd
Sandusky, OH 44870-8913

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
I20160920001623 OH Practitioner - Optometry 6305133372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14553 Madison Ave
Lakewood, OH 44107-4325
Phone (216) 227-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6197OHMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Sophia K. Fotinos O.D., LLC Optometrist CurrentSince Sep 6, 2016 Accepting new patients
America'S Best Contacts & Eyeglasses Past Accepting new patients

Locations

14553 Madison Ave
Lakewood, OH 44107
Phone (216) 226-8795

Organizations & group practices 2

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": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1316385362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 CROSSINGS RD",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448708913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 CROSSINGS RD",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448708913",
            "telephone_number": "419-626-5148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOTINOS",
        "first_name": "SOPHIA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

Verify at the official NPI Registry.