Individual provider Active NPI

Melanie A. Weese, OD

  • Optometrist
  • Racine, OH
National Provider Identifier
1740254267
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4242 Issued in OH
Practice address
109 N 3Rd St
Racine, OH 45771-0880
Phone
(740) 949-2078
Fax
(740) 949-2078
NPI assigned
Feb 13, 2006
Last updated
Mar 11, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4242 OH Primary

Addresses

Primary practice location

109 N 3Rd St
Racine, OH 45771-0880

Mailing address

PO Box 880
Racine, OH 45771-0880
Phone (740) 949-2078

Other identifiers 1

IdentifierTypeStateIssuer
0842575MedicaidOH

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
I20100607000130 OH Practitioner - Optometry 4789714460 Practice locations: Racine, OH

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

109 N 3Rd St
Racine, OH 45771-9552
Phone (740) 949-2078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205193600000",
    "number": "1740254267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 880",
            "city": "RACINE",
            "state": "OH",
            "postal_code": "457710880",
            "telephone_number": "740-949-2078",
            "fax_number": "740-949-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N 3RD ST",
            "city": "RACINE",
            "state": "OH",
            "postal_code": "457710880",
            "telephone_number": "740-949-2078",
            "fax_number": "740-949-2078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEESE",
        "first_name": "MELANIE",
        "middle_name": "A.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2008-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0842575",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, OH

Sources for this page

Verify at the official NPI Registry.