Individual provider Active NPI

Peter E Sforza Jr., O.D.

  • Optometrist
  • Girard, OH
National Provider Identifier
1538168596
Registry record updated Mar 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3968T1103 Issued in OH
Practice address
514 N State St
Girard, OH 44420-1745
Phone
(330) 545-3000
Fax
(330) 545-5390
NPI assigned
Jul 20, 2005
Reactivated
Mar 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 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 3968T1103 OH Primary

Addresses

Primary practice location

514 N State St
Girard, OH 44420-1745

Mailing address

514 N State St
Girard, OH 44420-1745
Phone (330) 545-3000

Other identifiers 1

IdentifierTypeStateIssuer
0718763MedicaidOH

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
I20100608000090 OH Practitioner - Optometry 6507828167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1987
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)

514 N State St
Girard, OH 44420-1745
Phone (330) 545-3000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3968T1103OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Ohio Professional PC Optometrist CurrentSince Mar 23, 2022 Accepting new patients
Aeg Ohio Professional PC Optometrist CurrentSince Mar 23, 2022 Accepting new patients

Locations

514 N State St
Girard, OH 44420
Phone (330) 545-3000

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

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206403200000",
    "number": "1538168596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 N STATE ST",
            "city": "GIRARD",
            "state": "OH",
            "postal_code": "444201745",
            "telephone_number": "330-545-3000",
            "fax_number": "330-545-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 N STATE ST",
            "city": "GIRARD",
            "state": "OH",
            "postal_code": "444201745",
            "telephone_number": "330-545-3000",
            "fax_number": "330-545-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SFORZA",
        "first_name": "PETER",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2008-03-25",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3968T1103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0718763",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Girard, OH

Sources for this page

Verify at the official NPI Registry.