Active NPI
Scott Douglas Fuldauer, O.D.
- Optometrist
- University Heights, OH
National Provider Identifier
1497745335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3733
- Practice address
- 20670 John Carroll Blvd
University Heights, OH 44118 - Phone
- (216) 534-4648
- NPI assigned
- Oct 23, 2005
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3733 | OH | Primary |
Addresses
Primary practice location
20670 John Carroll Blvd
University Heights, OH 44118
Mailing address
20670 John Carroll Blvd
University Heights, OH 44118-4535
Phone (216) 371-3242
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090401000006 | OH | Practitioner - Optometry | 1658438908 | Practice locations: University HTS, OH |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3733 | OH | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Park Optical | Past | Accepting new patients |
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": "1130025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1497745335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20670 JOHN CARROLL BLVD",
"city": "UNIVERSITY HEIGHTS",
"state": "OH",
"postal_code": "441184535",
"telephone_number": "216-371-3242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20670 JOHN CARROLL BLVD",
"city": "UNIVERSITY HEIGHTS",
"state": "OH",
"postal_code": "44118",
"telephone_number": "216-534-4648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULDAUER",
"first_name": "SCOTT",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-23",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "3733",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in University Heights, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.