Individual provider Active NPI

Alexander Junglas, OD

  • Optometrist
  • Willoughby, OH
National Provider Identifier
1770157448
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.006970 Issued in OH
Practice address
5900 Som Center Rd Ste 19
Willoughby, OH 44094-3044
Phone
(440) 585-2020
NPI assigned
May 18, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.006970 OH Primary

Addresses

Primary practice location

5900 Som Center Rd Ste 19
Willoughby, OH 44094-3044

Mailing address

5900 Som Center Rd Ste 19
Willoughby, OH 44094-3044
Phone (440) 585-2020

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
I20210615002063 OH Practitioner - Optometry 6901206820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
For Your Eyes Only, IncGroup PAC ID 3971493917, 3 clinicians

Practice addresses (Care Compare)

5900 Som Ctr Rd
Suite 19
Willoughby, OH 44094-3044
Phone (440) 585-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.006970OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
For Your Eyes Only, Inc Optometrist CurrentSince Jun 10, 2021 Accepting new patients
For Your Eyes Only, Inc. Optometrist CurrentSince Jul 25, 2021 Accepting new patients

Locations

5900 Som Center Rd
Ste 19
Willoughby, OH 44094
Phone (440) 585-2020

Organizations & group practices 2

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": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1770157448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 SOM CENTER RD STE 19",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440943044",
            "telephone_number": "440-585-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 SOM CENTER RD STE 19",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440943044",
            "telephone_number": "440-585-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNGLAS",
        "first_name": "ALEXANDER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-18",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.006970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

Verify at the official NPI Registry.