Individual provider Active NPI

Jamie Rosenberg, OD

  • Optometrist
  • Twinsburg, OH
National Provider Identifier
1689029795
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6493 Issued in OH
Practice address
9981 Vail Dr Unit A2
Twinsburg, OH 44087-4901
Phone
(540) 731-1010
NPI assigned
Apr 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6493 OH Primary

Addresses

Primary practice location

9981 Vail Dr Unit A2
Twinsburg, OH 44087-4901

Mailing address

9981 Vail Dr Unit A2
Twinsburg, OH 44087-4901
Phone (330) 583-4441

Other practice location 1

30851 Euclid Ave Ste 4
Willoughby, OH 44094-3198
Phone (440) 944-5155

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
I20170804002513 OH Practitioner - Optometry 2769753094 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mark F Kapusta OD IncGroup PAC ID 4284753484, 2 clinicians
Infinity Eye Care LLCGroup PAC ID 9739592015, 2 clinicians

Practice addresses (Care Compare)

30851 Euclid Ave
Suite 4
Willoughby, OH 44094-3198
Phone (440) 944-5155

9981 Vail Dr
Unit A2
Twinsburg, OH 44087-4901
Phone (330) 583-4441

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6493OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Ophthalmology Specialists, PLLC Optometrist Current Accepting new patients
Mark F. Kapusta O.D. Inc Optometrist CurrentSince Jun 25, 2023 Accepting new patients
Infinity Eye Care LLC Optometrist CurrentSince Jun 25, 2023 Accepting new patients

Locations

9981 Vail Dr
Unit A2
Twinsburg, OH 44087
Phone (330) 583-4441

30851 Euclid Ave
Ste 4
Willoughby, OH 44094
Phone (440) 944-5155

Interoperability endpoints

  • Direct secure messaging: jrosenberg@osm.intellechartdirect.net
  • Direct secure messaging: jamie.rosenberg@uprisedirect.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1689029795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9981 VAIL DR UNIT A2",
            "city": "TWINSBURG",
            "state": "OH",
            "postal_code": "440874901",
            "telephone_number": "330-583-4441",
            "fax_number": "330-583-4471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9981 VAIL DR UNIT A2",
            "city": "TWINSBURG",
            "state": "OH",
            "postal_code": "440874901",
            "telephone_number": "540-731-1010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30851 Euclid Ave Ste 4",
            "address_purpose": "LOCATION",
            "city": "Willoughby",
            "state": "OH",
            "postal_code": "440943198",
            "country_code": "US",
            "telephone_number": "440-944-5155",
            "fax_number": "440-943-9460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "JAMIE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-26",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twinsburg, OH

Sources for this page

Verify at the official NPI Registry.