Individual provider Active NPI

Robin M Maceyko, O.D.

  • Optometrist
  • Boardman, OH
National Provider Identifier
1356320477
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3524T944 Issued in OH
Practice address
8004 South Ave
Boardman, OH 44512-3642
Phone
(330) 726-1616
Fax
(330) 726-1682
NPI assigned
Jan 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3524T944 OH Primary

Addresses

Primary practice location

8004 South Ave
Boardman, OH 44512-3642

Mailing address

8004 South Ave
Boardman, OH 44512-6153
Phone (330) 726-1616

Other identifiers 1

IdentifierTypeStateIssuer
0573731MedicaidOH

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
I20080318000532 OH Practitioner - Optometry 4082619853 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Randall M .Maceyko, ODGroup PAC ID 9638174402, 3 clinicians
Eye Catchers Optical LLCGroup PAC ID 7810400652, 4 clinicians

Practice addresses (Care Compare)

8004 S Ave
Boardman, OH 44512-6153
Phone (330) 726-1616

915 Columbiana Canfield Rd
Columbiana, OH 44408-9457
Phone (330) 482-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3524T944OHMDOptometrist
3524OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Randall M Maceyko, OD Optometrist CurrentSince Apr 4, 2017 Accepting new patients
Eye Catchers Optical LLC Optometrist CurrentSince Apr 6, 2025 Accepting new patients

Locations

915 State Route 46
Ste 5
Columbiana, OH 44408
Phone (216) 482-1000

915 State Route 46
Columbiana, OH 44408
Phone (330) 482-1000

8004 South Ave
Youngstown, OH 44512
Phone (330) 726-1616

Organizations & group practices 3

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": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1356320477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8004 SOUTH AVE",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126153",
            "telephone_number": "330-726-1616",
            "fax_number": "330-726-1682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8004 SOUTH AVE",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445123642",
            "telephone_number": "330-726-1616",
            "fax_number": "330-726-1682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACEYKO",
        "first_name": "ROBIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-17",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3524T944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0573731",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.