Jamie R Anetakis, O.D.
Individual provider Active NPI Optometrist · Strongsville, OH
NPI 1477590610 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1477590610
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 5367 (OH)
- Practice address
- 122 Southpark Ctr
Strongsville, OH 44136-9316 - Phone
- (440) 572-4421
- NPI assigned
- May 31, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Ohio State University - College of Optometry, 2003
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Dr. George D. Poulos and Associates, Inc.
Practice addresses (Care Compare)
832 Great Northern Mall
North Olmsted, OH 44070-3300
Phone (440) 777-9904
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060829000180 | OH | Practitioner - Optometry | 8123920857 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5367 | OH | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. George D. Poulos & Associates, Inc. | Optometrist | Current |
Accepting new patients |
Locations
832 Great Northern Mall
North Olmsted, OH 44070
Phone (440) 777-3097
122 Southpark Ctr
Strongsville, OH 44136
Phone (440) 572-1666
17090 Royalton Rd
Strongsville, OH 44136
Phone (440) 572-4421
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5367 | OH | Yes |
Addresses
Primary practice location
122 Southpark Ctr
Strongsville, OH 44136-9316
Mailing address
122 Southpark Ctr
Strongsville, OH 44136-9316
Phone (440) 572-4421
Other providers in Strongsville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.