Individual provider Active NPI

Dina Mubarak, OD

  • Optometrist
  • Columbus, OH
National Provider Identifier
1801461249
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.006959 Issued in OH
Practice address
1379 Weybridge Rd
Columbus, OH 43220-8108
Phone
(614) 717-8283
NPI assigned
May 26, 2021
Last updated
May 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 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 OPT.006959 OH Primary

Addresses

Primary practice location

1379 Weybridge Rd
Columbus, OH 43220-8108

Mailing address

1379 Weybridge Rd
Columbus, OH 43220-8108

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
I20211019003275 OH Practitioner - Optometry 3577951839 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.006959OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Maria J. Fragoulis, Inc Optometrist CurrentSince Jul 20, 2021 Accepting new patients

Locations

5200 Westpointe Plaza Dr
Columbus, OH 43228
Phone (614) 876-6747

8659 Columbus Pike
Lewis Center, OH 43035
Phone (740) 657-1301

Organizations & group practices 1

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": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1801461249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1379 WEYBRIDGE RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432208108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1379 WEYBRIDGE RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432208108",
            "telephone_number": "614-717-8283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUBARAK",
        "first_name": "DINA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-26",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.006959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.