Individual provider Active NPI

David Trujillo, O.D.

  • Optometrist
  • Toledo, OH
National Provider Identifier
1639443930
Registry record updated Feb 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6079 Issued in OH
Practice address
3000 Regency CT
Suite 100
Toledo, OH 43623-3092
Phone
(419) 885-8444
NPI assigned
Mar 5, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6079 OH Primary

Addresses

Primary practice location

3000 Regency CT
Suite 100
Toledo, OH 43623-3092

Mailing address

1801 W Maumee St
Ste 100
Adrian, MI 49221-1291

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120618000297 OH Practitioner - Optometry 4880858141 Reassigns benefits to 1 organization
I20140604000488 MI Practitioner - Optometry 4880858141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DRS Ravin Birndorf and Ravin IncGroup PAC ID 2860487964, 7 clinicians

Practice addresses (Care Compare)

1801 W Maumee St
100 Specialty Eye Institute
Adrian, MI 49221-1291
Phone (517) 265-6131

3000 Regency CT
Suite 100
Toledo, OH 43623-3081
Phone (800) 832-2015

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.86 of 100Reported as group
Quality
98.78
Promoting interoperability
53
Improvement activities
40
Cost
76.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6079OHMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Ravin, Birndorf & Ravin, Inc. Optometrist CurrentSince Jul 1, 2014 Accepting new patients
Mid Michigan Eye Care Center, PC Optometrist Past Accepting new patients
The Cleveland Clinic Foundation Past Accepting new patients
Envision Icare, Inc Optometrist PastSince Nov 12, 2008 Accepting new patients

Locations

1801 W Maumee St
Ste 100
Adrian, MI 49221
Phone (517) 265-6131

580 Riverside Ave
Adrian, MI 49221
Phone (517) 265-6055

850 W North St
#104
Jackson, MI 49202
Phone (248) 647-9790

3000 Regency Ct
Ste 100
Toledo, OH 43623
Phone (419) 882-2020

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1639443930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W MAUMEE ST",
            "address_2": "STE 100",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 REGENCY CT",
            "address_2": "SUITE 100",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233092",
            "telephone_number": "419-885-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "DAVID",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-05",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.