Organization Active NPI

Olentangy Eye and Laser Associates, Inc.

  • Ophthalmology Physician
  • Columbus, OH
National Provider Identifier
1568412955
Registry record updated Jan 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
OLENTANGY EYE AND LASER ASSOCIATES, INC.
Practice address
3794 Olentangy River Rd.
Columbus, OH 43214-3455
Phone
(614) 267-4122
Fax
(614) 267-4242
NPI assigned
May 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2016

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

Authorized official

Name
Ms. Debbie Riegel
Title
Practice Manager
Phone
(614) 267-4122

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X OH Primary

Addresses

Primary practice location

3794 Olentangy River Rd.
Columbus, OH 43214-3455

Mailing address

3794 Olentangy River Rd.
Columbus, OH 43214-3455
Phone (614) 267-4122

Other identifiers 1

IdentifierTypeStateIssuer
2048573MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040210000741 OH Part B Supplier - Clinic/Group Practice 9537053624 Receives reassigned benefits from 1 practitioner
Practice locations: Columbus, OH

National Provider Directory

National Provider Directory

Locations

3794 Olentangy River Rd
Columbus, OH 43214
Phone (614) 267-4122

3525 Olentangy River Rd
Ste 5310
Columbus, OH 43214
Phone (614) 261-0073

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453852800000",
    "number": "1568412955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3794 OLENTANGY RIVER RD.",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143455",
            "telephone_number": "614-267-4122",
            "fax_number": "614-267-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3794 OLENTANGY RIVER RD.",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143455",
            "telephone_number": "614-267-4122",
            "fax_number": "614-267-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLENTANGY EYE AND LASER ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2016-01-27",
        "status": "A",
        "authorized_official_last_name": "RIEGEL",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "614-267-4122",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2048573",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.