Individual provider Active NPI

Jakob Tivis Zigulis, OD

  • Optometrist
  • Sandusky, OH
National Provider Identifier
1417799743
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.007304 Issued in OH
Practice address
2331 Columbus Ave
Sandusky, OH 44870-4827
Phone
(419) 626-0272
NPI assigned
Jun 7, 2024
Last updated
Jun 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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.007304 OH Primary

Addresses

Primary practice location

2331 Columbus Ave
Sandusky, OH 44870-4827

Mailing address

35430 Emory Dr
Avon, OH 44011-4921
Phone (419) 377-0288

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
I20240827000659 OH Practitioner - Optometry 4981143617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Ohio Professional PCGroup PAC ID 7618207036, 80 clinicians

Practice addresses (Care Compare)

2331 Columbus Ave
Sandusky, OH 44870-4827
Phone (419) 954-0300

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery56

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.007304OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Ohio Professional PC Optometrist CurrentSince Jul 1, 2024 Accepting new patients
Aeg Ohio Professional PC Optometrist CurrentSince Jul 1, 2024 Accepting new patients

Locations

111 E 4th St
Ste 440
Alton, IL 62002

2331 Columbus Ave
Sandusky, OH 44870
Phone (419) 626-0272

33541 Aurora Rd
Solon, OH 44139
Phone (440) 248-2020

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, 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": "1717718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1417799743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35430 EMORY DR",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440114921",
            "telephone_number": "419-377-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 COLUMBUS AVE",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448704827",
            "telephone_number": "419-626-0272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIGULIS",
        "first_name": "JAKOB",
        "middle_name": "TIVIS",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-07",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.007304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

Verify at the official NPI Registry.