Individual provider Active NPI

Thomas W. Flickinger, O.D., PH.D.

  • Optometrist
  • Fairlawn, OH
National Provider Identifier
1548270291
Registry record updated Nov 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4983/T1853 Issued in OH
Practice address
3040 W Market St
Fairlawn, OH 44333-3642
Phone
(330) 836-3828
Fax
(330) 836-3727
NPI assigned
Aug 8, 2006
Last updated
Nov 17, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4983/T1853 OH Primary

Addresses

Primary practice location

3040 W Market St
Fairlawn, OH 44333-3642

Mailing address

3040 W Market St
Fairlawn, OH 44333-3642
Phone (330) 836-3828

Other identifiers 1

IdentifierTypeStateIssuer
OP1649OtherEYEMED INSURANCE

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
I20100614000092 OH Practitioner - Optometry 5991835282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3040 W Market St
Fairlawn, OH 44333-3642
Phone (330) 836-3828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4983/T1853OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas Flickinger OD PHD LLC Optometrist CurrentSince Apr 15, 2002 Accepting new patients

Locations

3040 W Market St
Fairlawn, OH 44333
Phone (330) 836-3828

3040 W Market St
Ste 1
Fairlawn, OH 44333

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416182400000",
    "number": "1548270291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 W MARKET ST",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333642",
            "telephone_number": "330-836-3828",
            "fax_number": "330-836-3727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 W MARKET ST",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333642",
            "telephone_number": "330-836-3828",
            "fax_number": "330-836-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLICKINGER",
        "first_name": "THOMAS",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "O.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2014-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4983/T1853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED INSURANCE",
            "identifier": "OP1649",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

Verify at the official NPI Registry.