Individual provider Active NPI

Bennett J Paulus, OD

  • Optometrist
  • Fostoria, OH
National Provider Identifier
1750580163
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5736 Issued in OH
Practice address
799 N Vine St
Fostoria Eyecare Inc
Fostoria, OH 44830
Phone
(419) 435-3323
Fax
(419) 435-7834
NPI assigned
Jul 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5736 OH Primary
Optometrist 152W00000X T2650 OH

Addresses

Primary practice location

799 N Vine St
Fostoria Eyecare Inc
Fostoria, OH 44830

Mailing address

799 N Vine St
Fostoria, OH 44830
Phone (419) 435-3323

Other identifiers 1

IdentifierTypeStateIssuer
0921926MedicaidOH

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
I20071120000243 OH Practitioner - Optometry 1557459807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Findlay Optometry Clinic IncGroup PAC ID 9335173012, 6 clinicians

Practice addresses (Care Compare)

123 W Sandusky St
Findlay, OH 45840-3215
Phone (419) 422-3472

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery20

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T2650OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Findlay Optometry Clinic Inc Optometrist CurrentSince Jul 11, 2007 Accepting new patients

Locations

123 W Sandusky St
Findlay, OH 45840
Phone (419) 422-3472

314 W Lytle St
Fostoria, OH 44830
Phone (419) 435-3323

478 W Market St
Tiffin, OH 44883
Phone (419) 447-5616

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.

NPI Registry JSON

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1750580163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "799 N VINE ST",
            "city": "FOSTORIA",
            "state": "OH",
            "postal_code": "44830",
            "telephone_number": "419-435-3323",
            "fax_number": "419-435-7834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 N VINE ST",
            "address_2": "FOSTORIA EYECARE INC",
            "city": "FOSTORIA",
            "state": "OH",
            "postal_code": "44830",
            "telephone_number": "419-435-3323",
            "fax_number": "419-435-7834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULUS",
        "first_name": "BENNETT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-16",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5736",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "T2650",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0921926",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fostoria, OH

Sources for this page

Verify at the official NPI Registry.