Organization Active NPI

Optimal Eye Care LLC

  • Optometrist
  • Lewis Center, OH
National Provider Identifier
1780990879
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5946 Issued in OH
Legal business name
OPTIMAL EYE CARE LLC
Practice address
6433 Pullman Dr
Lewis Center, OH 43035-7377
Phone
(740) 548-0100
Fax
(740) 548-2122
NPI assigned
Aug 26, 2010
Last updated
Jun 5, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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

Authorized official

Name
Lori Guagenti-Engler, O.D.NPI 1609180488
Title
Owner
Phone
(419) 230-4704

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5946 OH Primary

Addresses

Primary practice location

6433 Pullman Dr
Lewis Center, OH 43035-7377

Mailing address

6433 Pullman Dr
Lewis Center, OH 43035-7377
Phone (740) 548-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101102001194 OH Part B Supplier - Clinic/Group Practice 7517151673 Receives reassigned benefits from 3 practitioners
Practice locations: Lewis Center, OH

National Provider Directory

National Provider Directory

Locations

6433 Pullman Dr
Lewis Center, OH 43035
Phone (740) 548-0100

6456 Pullman Dr
Lewis Center, OH 43035
Phone (740) 548-0100

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401926400000",
    "number": "1780990879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6433 PULLMAN DR",
            "city": "LEWIS CENTER",
            "state": "OH",
            "postal_code": "430357377",
            "telephone_number": "740-548-0100",
            "fax_number": "740-548-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6433 PULLMAN DR",
            "city": "LEWIS CENTER",
            "state": "OH",
            "postal_code": "430357377",
            "telephone_number": "740-548-0100",
            "fax_number": "740-548-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-26",
        "last_updated": "2014-06-05",
        "status": "A",
        "authorized_official_last_name": "GUAGENTI-ENGLER",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-230-4704",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewis Center, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.