Roxanna Thelma Potter, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT.005738 Issued in OH

Practice address

8254 Mayberry SQ N
Sylvania, OH 43560-9457

Phone

(419) 885-5300

Fax

(419) 885-5308

NPI assigned

Aug 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Roxanna Thelma Weisenbach Former name

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

Specialty

Optometry

Education

Ferris State College - College of Optometry, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Ohio, LLCGroup PAC ID 7719211010, 72 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Myeyedr Optometry of Ohio, LLC

  • Optometrist
  • Dayton, OH
  • NPI 1902365448
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Ohio, LLC

  • Optometrist
  • Sylvania, OH
  • NPI 1114480134
  NPD
• Myeyedr Optometry of Ohio, LLC

  • Optometrist
  • Warren, OH
  • NPI 1720970981
  NPD
• Myeyedr Optometry of Virginia, PLLC

  • Optometrist
  • Chesapeake, VA
  • NPI 1669820304
  NPD (past)

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1790797579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8254 MAYBERRY SQ N",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435609457",
            "telephone_number": "419-885-5300",
            "fax_number": "419-885-5308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "ROXANNA",
        "middle_name": "THELMA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.005738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2831467",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROXANNA",
            "last_name": "WEISENBACH",
            "middle_name": "THELMA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Optometrist in Sylvania, OH
• Providers in Sylvania, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.