Individual provider Active NPI

Ross W Collins, O.D., M.S.

  • Optometrist
  • Vandalia, OH
National Provider Identifier
1760673271
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5709 Issued in OH
Practice address
407 Corporate Center Dr
Ste C
Vandalia, OH 45377-1165
Phone
(937) 898-9333
Fax
(937) 898-0643
NPI assigned
Aug 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5709 OH Primary

Addresses

Primary practice location

407 Corporate Center Dr
Ste C
Vandalia, OH 45377-1165

Mailing address

407 Corporate Center Dr
Ste C
Vandalia, OH 45377-1165
Phone (937) 898-9333

Other identifiers 1

IdentifierTypeStateIssuer
2780790MedicaidOH

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
I20080204000480 OH Practitioner - Optometry 4789766387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

407 Corporate Ctr Dr
Suite C
Vandalia, OH 45377-1177
Phone (937) 898-9333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
5709OHMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Ross W Collins OD LLC Optometrist CurrentSince Oct 1, 2011 Accepting new patients

Locations

407 Corporate Center Dr
Ste C
Vandalia, OH 45377
Phone (937) 898-9333

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": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1760673271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 CORPORATE CENTER DR",
            "address_2": "STE C",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453771165",
            "telephone_number": "937-898-9333",
            "fax_number": "937-898-0643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 CORPORATE CENTER DR",
            "address_2": "STE C",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453771165",
            "telephone_number": "937-898-9333",
            "fax_number": "937-898-0643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "ROSS",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "O.D., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2780790",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vandalia, OH

Sources for this page

Verify at the official NPI Registry.