Gregory Sasarak Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

5592 Issued in OH

Legal business name

GREGORY SASARAK INC

Practice address

280 S Logan St
Elyria, OH 44035-6224

Phone

(440) 365-9311

Fax

(440) 366-5057

NPI assigned

Oct 11, 2012

Last updated

Oct 30, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gregory S Sasarak, O.D.NPI 1457429508

Title

Owner

Phone

(440) 365-9311

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gregory S Sasarak, O.D.

  • Optometrist
  • Elyria, OH
  • NPI 1457429508
  Medicare reassignment Authorized official
• Matthew David Grucella, OD

  • Optometrist
  • Brunswick, OH
  • NPI 1861596884
  NPD (past)
• Alecia R Palmer, O.D.

  • Optometrist
  • Lancaster, SC
  • NPI 1275535825
  NPD (past)

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1710239991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 S LOGAN ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356224",
            "telephone_number": "440-365-9311",
            "fax_number": "440-366-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 S LOGAN ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356224",
            "telephone_number": "440-365-9311",
            "fax_number": "440-366-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY SASARAK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-11",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "SASARAK",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-365-9311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OH",
            "license": "5592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2642840",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shawanda Grace
• Bethany Graham
• Andrea Green, STNA
• Dewayne C Green
• Jeffrey Gregg
• Melissa Marie Grey
• Aletta Griffea, QMHS
• Ryan M Griffith, M.D.
• Volinda Grissom
• Cynthia Marie Grizzell, RN

• Clinic/Center in Elyria, OH
• Providers in Elyria, OH by specialty
• Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.