Ronald Kevin Jurcak, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3865 Issued in OH

Practice address

16706 Chillicothe Rd 500
Chagrin Falls, OH 44023-4573

Phone

(440) 708-0020

Fax

(440) 708-0302

NPI assigned

Mar 1, 2007

Last updated

Sep 11, 2015By the provider in NPPES

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 2

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, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chagrin Valley Optometrists, IncGroup PAC ID 7315908951, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Chagrin Valley Optometrists, Inc

  • Optometrist
  • Chagrin Falls, OH
  • NPI 1548443302
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441929600000",
    "number": "1548398837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16706 CHILLICOTHE RD 500",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440234573",
            "telephone_number": "440-708-0020",
            "fax_number": "440-708-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16706 CHILLICOTHE RD 500",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440234573",
            "telephone_number": "440-708-0020",
            "fax_number": "440-708-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURCAK",
        "first_name": "RONALD",
        "middle_name": "KEVIN",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2015-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000228073",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2529900",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Chagrin Falls, OH
• Providers in Chagrin Falls, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; 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.