Organization Active NPI

The Eye Clinic Inc

  • Ophthalmology Physician
  • North Canton, OH
National Provider Identifier
1689937229
Registry record updated Sep 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
THE EYE CLINIC INC
Practice address
1605 Portage Rd NW
North Canton, OH 44720
Phone
(330) 433-1350
Fax
(330) 305-5021
NPI assigned
Jun 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2014

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

Authorized official

Name
Dr. Brian E Wind, D.O,
Title
President Corporation
Phone
(330) 837-5191

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1605 Portage Rd NW
North Canton, OH 44720

Mailing address

3545 Lincoln Way E
Suite a
Massillon, OH 44646-8624
Phone (330) 837-5191

Other identifiers 1

IdentifierTypeStateIssuer
0935895MedicaidOH

Other names 1

  • Perry Eye Clinic Inc Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051129001114 OH Part B Supplier - Clinic/Group Practice 4880614338 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
Practice locations: Massillon, OH; North Canton, OH
O20120821000238 OH DME Supplier - Physician - OptometristDME Supplier - Physician - Osteopathic Manipulative MedicineDME Supplier - Physician - Ophthalmology 4880614338 Practice locations: North Canton, OH

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
The Eye Clinic Inc1605 Portage St NW, North Canton, OH 44720-2264(330) 433-1350 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 1987

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410220800000",
    "number": "1689937229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 LINCOLN WAY E",
            "address_2": "SUITE A",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446468624",
            "telephone_number": "330-837-5191",
            "fax_number": "330-837-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 PORTAGE RD NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "44720",
            "telephone_number": "330-433-1350",
            "fax_number": "330-305-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EYE CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-19",
        "last_updated": "2014-09-09",
        "status": "A",
        "authorized_official_last_name": "WIND",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT CORPORATION",
        "authorized_official_telephone_number": "330-837-5191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O,"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0935895",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Perry Eye Clinic Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in North Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.