Individual provider Active NPI

Eric T. Combs, O.D.

  • Optometrist
  • Middletown, OH
National Provider Identifier
1679860753
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6024 Issued in OH
Practice address
1015 Summitt Dr
Middletown, OH 45042-3464
Phone
(513) 424-6267
Fax
(513) 425-9235
NPI assigned
Jul 8, 2011
Last updated
Jun 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6024 OH Primary

Addresses

Primary practice location

1015 Summitt Dr
Middletown, OH 45042-3464

Mailing address

1015 Summitt Dr
Middletown, OH 45042-3464
Phone (513) 424-6267

Other practice location 1

4883 Princeton Rd
Liberty Township, OH 45011-8057
Phone (513) 267-1928

Other identifiers 1

IdentifierTypeStateIssuer
0104074MedicaidOH

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110722000614 OH Practitioner - Optometry 1951579606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1015 Summitt Dr
Middletown, OH 45042-3464
Phone (513) 424-6267

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6024OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eric Combs, OD LLC Optometrist CurrentSince Jun 22, 2020 Accepting new patients

Locations

1015 Summit Dr
Middletown, OH 45042
Phone (513) 424-6267

Organizations & group practices 1

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": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1679860753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 SUMMITT DR",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450423464",
            "telephone_number": "513-424-6267",
            "fax_number": "513-425-9235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 SUMMITT DR",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450423464",
            "telephone_number": "513-424-6267",
            "fax_number": "513-425-9235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4883 Princeton Rd",
            "address_purpose": "LOCATION",
            "city": "Liberty Township",
            "state": "OH",
            "postal_code": "450118057",
            "country_code": "US",
            "telephone_number": "513-267-1928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COMBS",
        "first_name": "ERIC",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-08",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0104074",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

Verify at the official NPI Registry.