Individual provider Active NPI

Jennifer Lynn Mentessi, OD

  • Optometrist
  • North Royalton, OH
National Provider Identifier
1376645952
Registry record updated Jan 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5054 Issued in OH
Practice address
5690 Wallings Rd
North Royalton, OH 44133-3044
Phone
(440) 877-2020
Fax
(440) 877-9531
NPI assigned
Sep 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5054 OH Primary

Addresses

Primary practice location

5690 Wallings Rd
North Royalton, OH 44133-3044

Mailing address

5690 Wallings Rd
North Royalton, OH 44133-3044
Phone (440) 877-2020

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
I20080108000403 OH Practitioner - Optometry 4981784675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Distinctive Eyewear Inc.Group PAC ID 9638259328, 2 clinicians

Practice addresses (Care Compare)

5690 Wallings Rd
North Royalton, OH 44133-3044
Phone (440) 877-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5054OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Distinctive Eyewear Inc. Optometrist CurrentSince Aug 15, 2007 Accepting new patients

Locations

5690 Wallings Rd
North Royalton, OH 44133
Phone (440) 877-2020

Organizations & group practices 1

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1376645952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5690 WALLINGS RD",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441333044",
            "telephone_number": "440-877-2020",
            "fax_number": "440-877-9531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5690 WALLINGS RD",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441333044",
            "telephone_number": "440-877-2020",
            "fax_number": "440-877-9531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENTESSI",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Royalton, OH

Sources for this page

Verify at the official NPI Registry.