Individual provider Active NPI

Robert A Kriessler, OD

  • Optometrist
  • Willoughby, OH
National Provider Identifier
1619910700
Registry record updated Jan 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2663T934 Issued in OH
Practice address
5900 Som Center Road
Suite 19
Willoughby, OH 44094
Phone
(440) 585-2020
Fax
(440) 585-2044
NPI assigned
Jun 14, 2006
Last updated
Jan 3, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2663T934 OH Primary

Addresses

Primary practice location

5900 Som Center Road
Suite 19
Willoughby, OH 44094

Mailing address

5900 Som Center Road
Suite 19
Willoughby, OH 44094
Phone (440) 585-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2663T934OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
For Your Eyes Only, Inc. Optometrist PastSince Jul 25, 2021 Accepting new patients
Northern Ohio Eye Consultants Inc Optometrist Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199318400000",
    "number": "1619910700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 SOM CENTER ROAD",
            "address_2": "SUITE 19",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "44094",
            "telephone_number": "440-585-2020",
            "fax_number": "440-585-2044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 SOM CENTER ROAD",
            "address_2": "SUITE 19",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "44094",
            "telephone_number": "440-585-2020",
            "fax_number": "440-585-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIESSLER",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2008-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "2663T934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.