Individual provider Active NPI

Ryan Michael Cook, O.D.

  • Optometrist
  • Hopewell, VA
National Provider Identifier
1770845240
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618002143 Issued in VA
Practice address
221 E Broadway Ave
Hopewell, VA 23860-2809
Phone
(804) 458-5819
NPI assigned
Jun 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618002143 VA Primary

Addresses

Primary practice location

221 E Broadway Ave
Hopewell, VA 23860-2809

Mailing address

221 E Broadway Ave
Hopewell, VA 23860-2809
Phone (804) 458-5819

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20120802000357 VA Practitioner - Optometry 7517113871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lebow Eye Associates PCGroup PAC ID 2769478726, 3 clinicians

Practice addresses (Care Compare)

109 Wadsworth Dr
North Chesterfield, VA 23236-4521
Phone (804) 272-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618002143VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lebow Eye Associates, P.C. Optometrist CurrentSince Jun 13, 2012 Accepting new patients
Lebow Eye Associates, P.C. Optometrist CurrentSince Jun 13, 2012 Accepting new patients

Locations

221 E Broadway Ave
Hopewell, VA 23860
Phone (804) 458-5819

109 Wadsworth Dr
North Chesterfield, VA 23236
Phone (804) 272-2020

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": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1770845240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 E BROADWAY AVE",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238602809",
            "telephone_number": "804-458-5819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E BROADWAY AVE",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238602809",
            "telephone_number": "804-458-5819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-11",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopewell, VA

Sources for this page

Verify at the official NPI Registry.