Richard a. Statesir,MD Inc.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

053677 Issued in OH

Legal business name

RICHARD A. STATESIR,MD INC.

Practice address

14701 Detroit Ave
Suite 280
Lakewood, OH 44107-4115

Phone

(216) 228-9122

NPI assigned

Mar 30, 2010

Organization subpart

No

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

Authorized official

Name

Richard A. Statesir, MDNPI 1699778142

Title

Physician

Phone

(216) 228-9122

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 1

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

• Richard Allen Statesir, M.D.

  • Ophthalmology Physician
  • Lakewood, OH
  • NPI 1699778142
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328832000000",
    "number": "1699090936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14701 DETROIT AVE",
            "address_2": "SUITE 280",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441074115",
            "telephone_number": "216-228-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14701 DETROIT AVE",
            "address_2": "SUITE 280",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441074115",
            "telephone_number": "216-228-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD A. STATESIR,MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-30",
        "last_updated": "2012-02-10",
        "status": "A",
        "authorized_official_last_name": "STATESIR",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "216-228-9122",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "053677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Lakewood, OH
• Providers in Lakewood, OH by specialty
• Ophthalmology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.