Individual provider Active NPI

Peggy Harpster Maul, O.D.

  • Optometrist
  • Norwalk, OH
National Provider Identifier
1467494989
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.003512 Issued in OH
Practice address
112 Benedict Ave
Norwalk, OH 44857-2132
Phone
(419) 668-6067
Fax
(419) 663-6058
NPI assigned
Jun 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3512 T554 OH
Optometrist 152W00000X OPT.003512 OH Primary

Addresses

Primary practice location

112 Benedict Ave
Norwalk, OH 44857-2132

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other identifiers 2

IdentifierTypeStateIssuer
0479012MedicaidOH
142575OtherOHEYEMED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3512 T554OHMDOptometrist
OPT.003512OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Ohio, LLC Optometrist CurrentSince Aug 10, 2020 Accepting new patients
Myeyedr Optometry of Ohio, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Ohio, LLC Optometrist CurrentSince Aug 10, 2020 Accepting new patients

Locations

112 Benedict Ave
Norwalk, OH 44857
Phone (419) 668-6067

8254 Mayberry Sq N
Sylvania, OH 43560
Phone (419) 885-5300

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

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": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1467494989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 BENEDICT AVE",
            "city": "NORWALK",
            "state": "OH",
            "postal_code": "448572132",
            "telephone_number": "419-668-6067",
            "fax_number": "419-663-6058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUL",
        "first_name": "PEGGY",
        "middle_name": "HARPSTER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3512 T554",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.003512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0479012",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "142575",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, OH

Sources for this page

Verify at the official NPI Registry.