Active NPI
Zeana Bianca Bertacchi, O.D.
- Optometrist
- Cleveland, OH
National Provider Identifier
1619200789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5843
- Practice address
- 691 Richmond Rd
Cleveland, OH 44143-2990 - Phone
- (440) 461-1860
- NPI assigned
- Sep 8, 2009
- Last updated
- Sep 8, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5843 | OH | Primary |
Addresses
Primary practice location
691 Richmond Rd
Cleveland, OH 44143-2990
Mailing address
26800 Amhearst Cir
#304
Beachwood, OH 44122-7570
Phone (847) 648-6361
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120531000366 | IL | Practitioner - Optometry | 4183752298 | Practice locations: North Riversid, IL |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2500 Harlem Ave
North Riverside, IL 60546-1415
Phone (708) 853-1032
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5843 | OH | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252368000000",
"number": "1619200789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26800 AMHEARST CIR",
"address_2": "#304",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "441227570",
"telephone_number": "847-648-6361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "691 RICHMOND RD",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441432990",
"telephone_number": "440-461-1860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERTACCHI",
"first_name": "ZEANA",
"middle_name": "BIANCA",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-08",
"last_updated": "2009-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "5843",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; 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.