Individual provider Active NPI

John Anthony Kruszewski, O.D.

  • Optometrist
  • Toledo, OH
National Provider Identifier
1497757967
Registry record updated Oct 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3869 Issued in OH
Practice address
3723 King Rd
Suite100
Toledo, OH 43617-1417
Phone
(419) 843-2020
Fax
(419) 843-8733
NPI assigned
Aug 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3869 OH Primary

Addresses

Primary practice location

3723 King Rd
Suite100
Toledo, OH 43617-1417

Mailing address

3723 King Rd
Toledo, OH 43617-1417
Phone (419) 843-2020

Other identifiers 6

IdentifierTypeStateIssuer
000000137598OtherOHANTHEM
0580690001OtherOHDMERC
03067OtherOHPARAMOUNT
0814793MedicaidOH
22-00959OtherOHUNITED HEALTH CARE
900E86700OtherOHBCBS OF MICHIGAN

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
I20080114000164 OH Practitioner - Optometry 4789765041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Ohio Professional PCGroup PAC ID 7618207036, 80 clinicians

Practice addresses (Care Compare)

3723 King Rd
Suite 100
Toledo, OH 43617-1402
Phone (419) 843-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Ohio Professional PC Optometrist CurrentSince Jun 4, 2021 Accepting new patients
Aeg Ohio Professional PC Optometrist CurrentSince Jun 4, 2021 Accepting new patients
Robert C Layman OD Inc Optometrist Past Accepting new patients

Locations

33541 Aurora Rd
Solon, OH 44139
Phone (440) 248-2020

3723 King Rd
Ste 100
Toledo, OH 43617
Phone (419) 843-2020

3723 King Rd
Toledo, OH 43617

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": "1123891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225411200000",
    "number": "1497757967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3723 KING RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171417",
            "telephone_number": "419-843-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3723 KING RD",
            "address_2": "SUITE100",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171417",
            "telephone_number": "419-843-2020",
            "fax_number": "419-843-8733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSZEWSKI",
        "first_name": "JOHN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-13",
        "last_updated": "2008-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000137598",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0580690001",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT",
            "identifier": "03067",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0814793",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "22-00959",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "900E86700",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.