Individual provider Active NPI

Brian John Vanderploeg, O.D.

  • Optometrist
  • Newtown, OH
National Provider Identifier
1427101757
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5983 Issued in OH
Practice address
7397 Main St Ste I
Newtown, OH 45244-3034
Phone
(513) 991-7090
Fax
(513) 991-7091
NPI assigned
Jan 19, 2007
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1672DT KY
Optometrist 152W00000X 5983 OH Primary

Addresses

Primary practice location

7397 Main St Ste I
Newtown, OH 45244-3034

Mailing address

7397 Main St Ste I
Newtown, OH 45244-3034
Phone (513) 991-7090

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
I20100921000180 OH Practitioner - Optometry 2567554850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7397 Main St
Suite J
Newtown, OH 45244-3034
Phone (513) 991-7090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5983OHMDPsychologist
1672DTKYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Vanderploeg & Associates Inc Optometrist CurrentSince Jul 23, 2010 Accepting new patients

Locations

4601 Eastgate Blvd
Ste C578
Cincinnati, OH 45245
Phone (513) 753-4980

7397 Main St
Ste I
Newtown, OH 45244
Phone (513) 991-7090

7397 Main St
Ste J
Newtown, OH 45244
Phone (513) 753-4981

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, 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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1427101757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7397 MAIN ST STE I",
            "city": "NEWTOWN",
            "state": "OH",
            "postal_code": "452443034",
            "telephone_number": "513-991-7090",
            "fax_number": "513-991-7091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7397 MAIN ST STE I",
            "city": "NEWTOWN",
            "state": "OH",
            "postal_code": "452443034",
            "telephone_number": "513-991-7090",
            "fax_number": "513-991-7091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERPLOEG",
        "first_name": "BRIAN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1672DT",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown, OH

Sources for this page

Verify at the official NPI Registry.