Individual provider Active NPI

Alfred James Sugawara, O.D.

  • Optometrist
  • Fairfield, OH
National Provider Identifier
1780724823
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3584 T676 Issued in OH
Practice address
530 Wessel Dr
Fairfield, OH 45014-3650
Phone
(513) 367-6199
Fax
(513) 367-5085
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3584 T676 OH Primary

Addresses

Primary practice location

530 Wessel Dr
Fairfield, OH 45014-3650

Mailing address

8389 Cottonwood Dr
Cincinnati, OH 45231-5926
Phone (513) 931-6481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150112001315 OH Practitioner - Optometry 5991029464 Reassigns benefits to 2 organizations
I20170502001822 KY Practitioner - Optometry 5991029464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarkson Optometry Midwest IncGroup PAC ID 0749504165, 78 clinicians

Practice addresses (Care Compare)

10539 Harrison Ave
Harrison, OH 45030-1943
Phone (513) 367-6199

1650 S Union Ave
Alliance, OH 44601-4349
Phone (330) 821-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3584 T676OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gregory J Kuley and Assoc Optometrist Past Accepting new patients
20-20 Eyecare PSC Optometrist Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: alfredsugawara@direct.eyecare-partners.com

Organizations & group practices 3

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780724823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8389 COTTONWOOD DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452315926",
            "telephone_number": "513-931-6481",
            "fax_number": "513-367-5085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 WESSEL DR",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450143650",
            "telephone_number": "513-367-6199",
            "fax_number": "513-367-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUGAWARA",
        "first_name": "ALFRED",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3584 T676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.