NPIMap

Organization Active NPI

Ohio Eye Optometric, LLC

  • Eyewear Supplier
  • Ontario, OH
National Provider Identifier
1548081698
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
OHIO EYE OPTOMETRIC, LLC
Practice address
1991 Park Ave W
Ontario, OH 44906-2233
Phone
(419) 756-8000
NPI assigned
Oct 22, 2024
Organization subpart
Yes
Parent organization
OHIO EYE OPTOMETRIC, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Authorized official

Name
Stacy Ellis
Title
Credentialing Specialist
Phone
(419) 774-3402

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

1991 Park Ave W
Ontario, OH 44906-2233

Mailing address

466 S Trimble Rd
Mansfield, OH 44906-3416
Phone (419) 756-8000

Other identifiers 1

IdentifierTypeStateIssuer
S3838OtherOHNON MEDICARE

Other names 1

  • OEO Optical Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250421002840 OH DME Supplier - Physician - OptometristDME Supplier - Optician 7012144876 Practice locations: Ontario, OH

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Ohio Eye Optometric LLC1991 Park Ave W, Ontario, OH 44906-2233(419) 756-8000 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Nov 1, 2013

National Provider Directory

National Provider Directory
Tax ID family
Ohio Eye Optometric LLC8 organizations share this tax ID, including this one
Part of
Ohio Eye Optometric LLC

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1991 Park Ave W
Ontario, OH 44906
Phone (419) 521-3937

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1729555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1548081698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "466 S TRIMBLE RD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449063416",
            "telephone_number": "419-756-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 PARK AVE W",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449062233",
            "telephone_number": "419-756-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO EYE OPTOMETRIC, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OHIO EYE OPTOMETRIC, LLC",
        "enumeration_date": "2024-10-22",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "419-774-3402"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NON MEDICARE",
            "identifier": "S3838",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OEO Optical",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ontario, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.