Cleveland Society for the Blind

Organization Active NPI Optometrist · Cleveland, OH

NPI 1770643140 · NPPES record last updated Jun 19, 2015

Key facts

NPI
1770643140
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
Legal business name
CLEVELAND SOCIETY FOR THE BLIND
Practice address
1909 East 101 Street
Cleveland, OH 44106
Phone
(216) 791-8118
Fax
(216) 791-1101
NPI assigned
Dec 8, 2006
Organization subpart
No

Authorized official

Name
Mr. Kevin R Krencisz
Title
Cfo
Phone
(216) 791-8118

Corporate family (same tax ID) 1

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

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070822000071 OH Part B Supplier - Clinic/Group Practice 3173615283 Receives reassigned benefits from 9 practitioners
Practice locations: Cleveland, OH

National Provider Directory

Tax ID family
Cleveland Sight Center (2 organizations share this tax ID)

Locations

1909 E 101st St
Ste 216
Cleveland, OH 44106

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101Y00000X
Optometrist
Group: 193200000X MULTI-SPECIALTY GROUP
152W00000X Yes
Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225X00000X
Case Management Agency 251B00000X

Addresses

Primary practice location

1909 East 101 Street
Cleveland, OH 44106

Mailing address

1909 East 101 Street
Cleveland, OH 44106
Phone (216) 791-8118

Other identifiers

IdentifierTypeStateIssuer
0857087MedicaidOH

Other names

  • Cleveland Sight Center Doing business as

Other providers in Cleveland, OH

All providers in Cleveland, OH · Optometrist in Ohio

Sources for this page

Verify at the official NPI Registry.