Individual provider Active NPI

Maryellen Swartz Luebbers, O.D.

  • Optometrist
  • Columbus, OH
National Provider Identifier
1396799391
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5561 Issued in OH
Practice address
1421 Grandview Ave
Columbus, OH 43212-2853
Phone
(614) 488-2020
Fax
(614) 488-0763
NPI assigned
May 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5561 OH Primary

Addresses

Primary practice location

1421 Grandview Ave
Columbus, OH 43212-2853

Mailing address

1421 Grandview Ave
Columbus, OH 43212-2853
Phone (614) 488-2020

Other names 1

  • Maryellen Swartz Former name

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
I20060605000014 OH Practitioner - Optometry 9133130248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DWB IncGroup PAC ID 0244251726, 2 clinicians

Practice addresses (Care Compare)

1421 Grandview Ave
Eye Designs Grandvie
Columbus, OH 43212-2853
Phone (614) 488-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5561OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
DWB, Inc Optometrist CurrentSince Jul 18, 2005 Accepting new patients
Eye Designs New Albany, Inc Optometrist PastSince Jul 1, 2005 Accepting new patients

Locations

1421 Grandview Ave
Grandview, OH 43212
Phone (614) 488-2020

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1396799391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 GRANDVIEW AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432122853",
            "telephone_number": "614-488-2020",
            "fax_number": "614-488-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 GRANDVIEW AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432122853",
            "telephone_number": "614-488-2020",
            "fax_number": "614-488-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUEBBERS",
        "first_name": "MARYELLEN",
        "middle_name": "SWARTZ",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYELLEN",
            "last_name": "SWARTZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.