Alexander Jacob Desalvo, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT.006972 Issued in OH

Practice address

840 W Boundary St
Perrysburg, OH 43551-1702

Phone

(419) 931-2020

Fax

(419) 783-1445

NPI assigned

May 24, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

University of Pikeville, Kentucky College of Osteopathic Med, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eyes on Main Optometry LLCGroup PAC ID 6800943325, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eyes on Main Optometry LLC

  • Optometrist
  • Ada, OH
  • NPI 1730378373
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Ohio, LLC

  dba MyEyeDr.

  • Optometrist
  • Dayton, OH
  • NPI 1902365448
  Medicare reassignment NPD
• Eyes on Main Optometry LLC

  dba Eyes on Main

  • Optometrist
  • Findlay, OH
  • NPI 1861370819
  NPD
• Myeyedr Optometry of Ohio, LLC

  dba MyEyeDr.

  • Optometrist
  • Warren, OH
  • NPI 1720970981
  NPD
• Myeyedr Optometry of Ohio, LLC

  dba MyEyeDr.

  • Optometrist
  • Marion, OH
  • NPI 1952863094
  NPD

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1750956686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 W BOUNDARY ST",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435511702",
            "telephone_number": "419-931-2020",
            "fax_number": "419-783-1445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 S 3rd St",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "OH",
            "postal_code": "457503111",
            "country_code": "US",
            "telephone_number": "740-373-2069",
            "fax_number": "740-336-7887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESALVO",
        "first_name": "ALEXANDER",
        "middle_name": "JACOB",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-24",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.006972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Mary Declark
• Dentist in Perrysburg LLC (Dentist in Perrysburg)
• Kaitlyn Depew, OTR/L
• Dermatology Associates Inc
• Avram Derrow, M.D.
• Sean Deshuk
• Hanna Marie Dettinger
• Kirsten Leigh Dettinger
• James Russell Detwiler, D.D.S.
• Ashley M Devore, OTD, OTR/L

• Optometrist in Perrysburg, OH
• Providers in Perrysburg, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; 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.

Verify at the official NPI Registry.