Individual provider Active NPI

Joseph D Schwallie Jr., O.D.

  • Optometrist
  • Holland, OH
National Provider Identifier
1386649820
Registry record updated Nov 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4232 Issued in OH
Practice address
7121 Orchard Centre Dr
Holland, OH 43528-7975
Phone
(419) 865-7125
Fax
(419) 865-8337
NPI assigned
Jun 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4232 OH Primary

Addresses

Primary practice location

7121 Orchard Centre Dr
Holland, OH 43528-7975

Mailing address

7121 Orchard Centre Dr
Holland, OH 43528-7975
Phone (419) 865-7125

Other identifiers 1

IdentifierTypeStateIssuer
0851123OtherOHMEDICARE PIN FOR GW

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
I20100503000337 OH Practitioner - Optometry 2961396403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7111 Orchard Centre Dr
Holland, OH 43528-7974
Phone (419) 865-7125

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Patrick Henry OD LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195430400000",
    "number": "1386649820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7121 ORCHARD CENTRE DR",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435287975",
            "telephone_number": "419-865-7125",
            "fax_number": "419-865-8337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7121 ORCHARD CENTRE DR",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435287975",
            "telephone_number": "419-865-7125",
            "fax_number": "419-865-8337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWALLIE",
        "first_name": "JOSEPH",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2007-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN FOR GW",
            "identifier": "0851123",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, OH

Sources for this page

Verify at the official NPI Registry.