Samantha Zaczyk, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT.6420 Issued in OH

Practice address

2013 State Route 59
Kent, OH 44240-4113

Phone

(330) 678-0201

Fax

(330) 678-4604

NPI assigned

Jun 11, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

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

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Ohio Eye Surgeons IncGroup PAC ID 3577537042, 32 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.48 of 100Reported as group

Quality

77.53

Promoting interoperability

96

Improvement activities

40

Cost

77.39

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 and National Provider Directory roles.

• Northeast Ohio Eye Surgeons, Inc.

  • Optometrist
  • Kent, OH
  • NPI 1932208733
  Medicare reassignment Care Compare group NPD
• Northeast Ohio Eye Surgeons, Inc.

  • Ophthalmology Physician
  • Medina, OH
  • NPI 1093316671

  Optometrist

  NPD

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1609257070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 STATE ROUTE 59",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442404113",
            "telephone_number": "330-678-0201",
            "fax_number": "330-678-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2013 STATE ROUTE 59",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442404113",
            "telephone_number": "330-678-0201",
            "fax_number": "330-678-4604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 Portage Trl",
            "address_2": "#2",
            "address_purpose": "LOCATION",
            "city": "Cuyahoga Falls",
            "state": "OH",
            "postal_code": "442232121",
            "country_code": "US",
            "telephone_number": "330-923-9951",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4099 Embassy Pkwy",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443331781",
            "country_code": "US",
            "telephone_number": "330-678-0201",
            "fax_number": "330-678-4604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZACZYK",
        "first_name": "SAMANTHA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6420",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "OH",
            "license": "OPT.6420",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "OH",
            "license": "OPT.6420",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.6420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abiyah Yisrael
• Elizabeth Ann Yost, MSW, LSW
• Jessica Jacqueline Yost, RD
• Michael Young
• Robert C. Young, LICDC
• Katherine Hastings Zajac, O.D.
• Shelly Zarbailov, CNP
• Jessica Marie Zeitz, ATC
• Lori Zerhouane, SLP
• Joseph J Ziarko, LICDC

• Optometrist in Kent, OH
• Providers in Kent, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; 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.