Individual provider Active NPI

Anthony Michael Prusinski, O.D.

  • Optometrist
  • Mansfield, OH
National Provider Identifier
1457375511
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4978 Issued in OH
Practice address
2214 Richland Mall
Mansfield, OH 44906-1249
Phone
(419) 529-5770
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 4978 OH Primary

Addresses

Primary practice location

2214 Richland Mall
Mansfield, OH 44906-1249

Mailing address

5440 Brook Run Dr
Medina, OH 44256-6442
Phone (330) 725-7618

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
I20061127000288 OH Practitioner - Optometry 1951203173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prusinski Eye Care IncGroup PAC ID 2163529611, 3 clinicians

Practice addresses (Care Compare)

2214 Richland Mall
Mansfield, OH 44906-1249
Phone (419) 529-8085

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2718WIMDHealth Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Prusinski Eye Care, Inc. Optometrist CurrentSince May 1, 2007 Accepting new patients
Dr. Jonathan M. Schonfeld, Inc. Optometrist PastSince May 1, 2007 Accepting new patients
Luxottica Retail North America Inc Past Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

2214 Richland Mall
Mansfield, OH 44906
Phone (419) 529-5770

Organizations & group practices 4

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457375511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 BROOK RUN DR",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442566442",
            "telephone_number": "330-725-7618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2214 RICHLAND MALL",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449061249",
            "telephone_number": "419-529-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUSINSKI",
        "first_name": "ANTHONY",
        "middle_name": "MICHAEL",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

Verify at the official NPI Registry.