Active NPI
Distinctive Eyewear Inc.
- Optometrist
- North Royalton, OH
National Provider Identifier
1578760468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5054
- Legal business name
- DISTINCTIVE EYEWEAR INC.
- Practice address
- 5690 Wallings Rd
North Royalton, OH 44133-3044 - Phone
- (440) 877-2020
- Fax
- (440) 877-9531
- NPI assigned
- Jul 2, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jennifer Lynn Mentessi, O.D.
- Title
- President
- Phone
- (440) 877-2020
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5054 | OH | Primary |
| Optician | 156FX1800X | OH |
Addresses
Primary practice location
5690 Wallings Rd
North Royalton, OH 44133-3044
Mailing address
5690 Wallings Rd
North Royalton, OH 44133-3044
Phone (440) 877-2020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
5690 Wallings Rd
North Royalton, OH 44133
Phone (440) 877-2020
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- North Royalton, OH
- NPI 1376645952
-
- Optometrist
- North Royalton, OH
- NPI 1376598656
-
- Optician
- North Royalton, OH
- NPI 1588677223
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183334400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1452643200000",
"number": "1578760468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5690 WALLINGS RD",
"city": "NORTH ROYALTON",
"state": "OH",
"postal_code": "441333044",
"telephone_number": "440-877-2020",
"fax_number": "440-877-9531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5690 WALLINGS RD",
"city": "NORTH ROYALTON",
"state": "OH",
"postal_code": "441333044",
"telephone_number": "440-877-2020",
"fax_number": "440-877-9531"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DISTINCTIVE EYEWEAR INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-07-02",
"last_updated": "2016-01-13",
"status": "A",
"authorized_official_last_name": "MENTESSI",
"authorized_official_first_name": "JENNIFER",
"authorized_official_middle_name": "LYNN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "440-877-2020",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist",
"state": "OH",
"license": "5054",
"primary": true
},
{
"code": "156FX1800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Technician/Technologist, Optician",
"state": "OH",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Royalton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.