Individual provider Active NPI

Igor E Estrovich, M.D.

  • Ophthalmology Physician
  • Lyndhurst, OH
National Provider Identifier
1770800138
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
35.123256 Issued in OH
Practice address
29001 Cedar Rd Ste 110
Lyndhurst, OH 44124-4041
Phone
(216) 382-8022
Fax
(216) 382-7667
NPI assigned
Apr 26, 2010
Last updated
Jun 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT195374 PA
Ophthalmology Physician 207W00000X MD161853 OR
Ophthalmology Physician 207W00000X 35.123256 OH Primary

Addresses

Primary practice location

29001 Cedar Rd Ste 110
Lyndhurst, OH 44124-4041

Mailing address

PO Box 378
Sandusky, OH 44871-0378
Phone (419) 626-6161

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140807000639 OH Practitioner - Ophthalmology 0840434098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Ohio Eye Center, Inc.Group PAC ID 7012056781, 6 clinicians

Practice addresses (Care Compare)

6355 Pearl Rd
Parma Heights, OH 44130-3000
Phone (440) 886-2020

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.123256OHMDOphthalmology Physician
MT195374PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Ohio Eye Center, Inc. Ophthalmology CurrentSince May 1, 2017 Accepting new patients
Vision Surgery Center, LLC Current Accepting new patients
Ophthalmology & Oculoplastic Surgery Inc Ophthalmology Past Accepting new patients
Ophthalmic Physicians Inc Ophthalmology Past Accepting new patients
Stamm Cataract and Laser Center Inc Ophthalmology PastSince Mar 15, 2022 Accepting new patients

Locations

6355 Pearl Rd
Parma Heights, OH 44130
Phone (440) 886-1010

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1770800138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 378",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448710378",
            "telephone_number": "419-626-6161",
            "fax_number": "419-502-3511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29001 CEDAR RD STE 110",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441244041",
            "telephone_number": "216-382-8022",
            "fax_number": "216-382-7667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTROVICH",
        "first_name": "IGOR",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-26",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT195374",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OR",
            "license": "MD161853",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35.123256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyndhurst, OH

Sources for this page

Verify at the official NPI Registry.