Active NPI
Ellen G Pruneau
- Optometrist
- Marysville, OH
National Provider Identifier
1710625223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT.007079
- Practice address
- 1550 London Ave
Marysville, OH 43040-8988 - Phone
- (937) 553-2020
- NPI assigned
- May 24, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT.007079 | OH | Primary |
Addresses
Primary practice location
1550 London Ave
Marysville, OH 43040-8988
Mailing address
1550 London Ave
Marysville, OH 43040-8988
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Ohio State University - College of Optometry, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1550 London Ave
Marysville, OH 43040-8988
Phone (937) 553-2020
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.6 of 100
- Quality
- 100
- Improvement activities
- 40
- Cost
- 72
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT.007079 | OH | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agnone, Morrison and Associates Eye Physicians and Surgeons Inc | Current | Accepting new patients |
Locations
1550 London Ave
Marysville, OH 43040
Phone (937) 553-2020
Interoperability endpoints
- esmith@ama.intellechartdirect.net
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 and National Provider Directory roles.
-
- Ophthalmology Physician
- Marysville, OH
- NPI 1174607733
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743465600000",
"number": "1710625223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1550 LONDON AVE",
"city": "MARYSVILLE",
"state": "OH",
"postal_code": "430408988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1550 LONDON AVE",
"city": "MARYSVILLE",
"state": "OH",
"postal_code": "430408988",
"telephone_number": "937-553-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUNEAU",
"first_name": "ELLEN",
"middle_name": "G",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-24",
"last_updated": "2025-04-01",
"certification_date": "2025-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "OPT.007079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marysville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.