NPIMap

Organization Active NPI

Philip Skovira OD Inc

  • Optometrist
  • Mayfield HTS, OH
National Provider Identifier
1760507743
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3375 T 653 Issued in OH
Legal business name
PHILIP SKOVIRA OD INC
Practice address
1409 Golden Gate Blvd
Mayfield HTS, OH 44124
Phone
(440) 544-1351
NPI assigned
Mar 20, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Philip Skovira, ODNPI 1437273836
Title
President
Phone
(440) 544-1351

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3375 T 653 OH Primary

Addresses

Primary practice location

1409 Golden Gate Blvd
Mayfield HTS, OH 44124

Mailing address

6513 Gates Mills Blvd
Mayfield HTS, OH 44124
Phone (440) 442-5745

Other identifiers 1

IdentifierTypeStateIssuer
0380574MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Philip Skovira OD Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760507743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6513 GATES MILLS BLVD",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "44124",
            "telephone_number": "440-442-5745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 GOLDEN GATE BLVD",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "44124",
            "telephone_number": "440-544-1351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP SKOVIRA OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SKOVIRA",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-544-1351",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3375 T 653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0380574",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield HTS, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.