Individual provider Active NPI

Toral N Desai, O.D.

  • Optometrist
  • Beavercreek, OH
National Provider Identifier
1780772442
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5546 Issued in OH
Practice address
3464 Pentagon Park Blvd
Beavercreek, OH 45431
Phone
(937) 429-4060
Fax
(937) 429-9675
NPI assigned
Oct 10, 2006
Last updated
Sep 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 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 5546 OH Primary

Addresses

Primary practice location

3464 Pentagon Park Blvd
Beavercreek, OH 45431

Mailing address

2629 McKinley PL
Beavercreek, OH 45431
Phone (937) 689-9029

Other identifiers 1

IdentifierTypeStateIssuer
2679589MedicaidOH

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
I20070105000148 OH Practitioner - Optometry 4082614615 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5546OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family First Vision Care Kentucky, LLC Optometrist CurrentSince Feb 15, 2021 Accepting new patients
Family First Vision Care Kentucky, LLC Optometrist PastSince Jul 2, 2023 Accepting new patients

Locations

2850 Centre Dr
Ste 6A
Beavercreek, OH 45324
Phone (937) 294-4060

3464 Pentagon Blvd
Beavercreek, OH 45431
Phone (937) 429-4060

2735 Miamisburg Centerville Rd
Dayton, OH 45459
Phone (937) 399-4060

3373 Princeton Rd
Ste 121
Fairfield Township, OH 45011
Phone (513) 893-1461

316 S Hamilton Rd
Gahanna, OH 43230

2051 N Bechtle Ave
Ste 130
Springfield, OH 45504
Phone (212) 729-5303

5274 Salem Ave
Trotwood, OH 45426
Phone (937) 837-3937

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1780772442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2629 MCKINLEY PL",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "45431",
            "telephone_number": "937-689-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3464 PENTAGON PARK BLVD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "45431",
            "telephone_number": "937-429-4060",
            "fax_number": "937-429-9675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "TORAL",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2679589",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.