Jeffrey Jay Borodkin, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3783 Issued in OH

Practice address

2820 W Market St
Suite 140
Fairlawn, OH 44333-4043

Phone

(330) 253-2436

Fax

(330) 253-2437

NPI assigned

Oct 20, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Ohio State University - College of Optometry, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Berris Optical of University HTS Inc

  • Eyewear Supplier
  • Cleveland, OH
  • NPI 1104084250
  NPD (past)
• Glasses by Berris Inc.

  • Eyewear Supplier
  • Cleveland, OH
  • NPI 1023258167
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400803200000",
    "number": "1508855669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 W MARKET ST",
            "address_2": "SUITE 140",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443334043",
            "telephone_number": "330-253-2436",
            "fax_number": "330-253-2437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 W MARKET ST",
            "address_2": "SUITE 140",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443334043",
            "telephone_number": "330-253-2436",
            "fax_number": "330-253-2437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORODKIN",
        "first_name": "JEFFREY",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2014-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0720483",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric H. Boettcher
• Laurie Ann Bohrer, LPCC
• Tina Bolha
• Elise Bondy
• Lesley Booher
• Kayla Boros
• Elon Bortz
• Ashley Bosserman
• Mariam Boulos, OTD, OTR/L
• Dina Youseff Boutros, M.D.

• Optometrist in Fairlawn, OH
• Providers in Fairlawn, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.