Perrysburg Eye Center, Inc.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

PERRYSBURG EYE CENTER, INC.

Practice address

28370 Kensington LN
Suite a
Perrysburg, OH 43551-4163

Phone

(419) 874-3125

Fax

(419) 874-8606

NPI assigned

Jul 7, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Stephen E Clark, M.D.NPI 1134122948

Title

President/Medical Director

Phone

(419) 874-3125

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Perrysburg Eye Center, Inc.

  • Eyewear Supplier
  • Perrysburg, OH
  • NPI 1467469486

  2567483092

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Tax ID family

Perrysburg Eye Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Perrysburg Eye Center, Inc.

  • Eyewear Supplier
  • Perrysburg, OH
  • NPI 1467469486
  NPD tax ID

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/imedicware_perrysburgeye

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephen E. Clark, M.D.

  • Ophthalmology Physician
  • Perrysburg, OH
  • NPI 1134122948
  Medicare reassignment Care Compare group NPD Authorized official
• Reed T Roth, O.D.

  • Optometrist
  • Perrysburg, OH
  • NPI 1679576474
  Medicare reassignment Care Compare group NPD
• Erica Leigh Smith, O.D.

  • Optometrist
  • Chillicothe, OH
  • NPI 1750956538
  Medicare reassignment Care Compare group NPD
• Lisa L Nirode, O.D.

  • Optometrist
  • Toledo, OH
  • NPI 1528012077
  Medicare reassignment Care Compare group
• Jeffrey Scott Stewart, OD

  • Optometrist
  • Findlay, OH
  • NPI 1790764702
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410307200000",
    "number": "1366475139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28370 KENSINGTON LN",
            "address_2": "SUITE A",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435514163",
            "telephone_number": "419-874-3125",
            "fax_number": "419-874-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28370 KENSINGTON LN",
            "address_2": "SUITE A",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435514163",
            "telephone_number": "419-874-3125",
            "fax_number": "419-874-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRYSBURG EYE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2014-09-10",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "419-874-3125",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2415265",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Perrysburg Chiropractic, Inc
• Perrysburg City Office of Corporation Clerk
• Perrysburg Commons Senior Housing-Perrysburg Oh LLC
• Perrysburg Counseling Services, LLC
• Perrysburg Exempted Village School District
• Perrysburg Eye Center, Inc.
• Perrysburg Family Physicians LLC
• Perrysburg Ft Meigs Family Practice
• Perrysburg Healthcare and Rehabilitation Center LLC
• Perrysburg Hearing Center LLC

• Ophthalmology Physician in Perrysburg, OH
• Providers in Perrysburg, OH by specialty
• Ophthalmology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.