Individual provider Active NPI

Elena Vourvopoulos, OD

  • Optometrist
  • Fairview Park, OH
National Provider Identifier
1407464209
Registry record updated Jul 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.006909 Issued in OH
Practice address
3580 Westgate
Fairview Park, OH 44126-1300
Phone
(440) 356-4020
NPI assigned
Jul 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.006909 OH Primary

Addresses

Primary practice location

3580 Westgate
Fairview Park, OH 44126-1300

Mailing address

1788 Hunters Point LN
Westlake, OH 44145-3648
Phone (440) 759-4678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210924001181 FL Practitioner - Optometry 4486070273 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vip Eye Care and Optical Boutique at Carillon LLC Optometrist CurrentSince Jun 19, 2023 Accepting new patients
Jennifer L Manning OD PA Optometrist PastSince Sep 13, 2021 Accepting new patients

Locations

12425 28th St N
Ste 103
St Petersburg, FL 33716
Phone (727) 295-0500

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": "1594944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1407464209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1788 HUNTERS POINT LN",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441453648",
            "telephone_number": "440-759-4678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 WESTGATE",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441261300",
            "telephone_number": "440-356-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOURVOPOULOS",
        "first_name": "ELENA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-17",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.006909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairview Park, OH

Sources for this page

Verify at the official NPI Registry.