Individual provider Active NPI

Peter M Schmid

  • Optometrist
  • Streetsboro, OH
National Provider Identifier
1508807165
Registry record updated Aug 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4767 Issued in OH
Practice address
1155 State Route 303
Streetsboro, OH 44241-3969
Phone
(330) 422-9999
Fax
(330) 422-0316
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 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 4767 OH Primary

Addresses

Primary practice location

1155 State Route 303
Streetsboro, OH 44241-3969

Mailing address

1155 State Route 303
Streetsboro, OH 44241-3969
Phone (330) 422-9999

Other identifiers 2

IdentifierTypeStateIssuer
0753797MedicaidOH
1325590001OtherOHADMINISTAR FEDERAL

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
I20040924000685 OH Practitioner - Optometry 4082685565 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4767OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Western Reserve Eye Associates, Inc. Optometrist CurrentSince May 15, 2000 Accepting new patients
Cei Physicians PSC LLC Optometrist Past Accepting new patients

Locations

1558 Akron Peninsula Rd
Akron, OH 44313
Phone (330) 922-0828

6880 W Snowville Rd
Ste 215
Brecksville, OH 44141
Phone (440) 526-1974

1520 Portage Trl
Cuyahoga Fls, OH 44223
Phone (330) 422-9999

1155 State Route 303
Streetsboro, OH 44241
Phone (330) 422-2020

Organizations & group practices 2

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219795200000",
    "number": "1508807165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 STATE ROUTE 303",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442413969",
            "telephone_number": "330-422-9999",
            "fax_number": "330-422-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 STATE ROUTE 303",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442413969",
            "telephone_number": "330-422-9999",
            "fax_number": "330-422-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMID",
        "first_name": "PETER",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2008-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0753797",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINISTAR FEDERAL",
            "identifier": "1325590001",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Streetsboro, OH

Sources for this page

Verify at the official NPI Registry.