Matthew Eidom, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT.007165 Issued in OH

Practice address

3580 Westgate
Fairview Park, OH 44126-1300

Phone

(440) 356-4020

Fax

(440) 356-4022

NPI assigned

May 25, 2023

Last updated

Mar 15, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Southern College of Optometry, 2023

Medicare assignment

May accept Medicare assignment

Group practices

Summit Family Vision LLCGroup PAC ID 4688905003, 4 clinicians

Westgate Optometry LLCGroup PAC ID 0042539389, 2 clinicians

Belden Optometry LLCGroup PAC ID 6709161532, 4 clinicians

Practice addresses (Care Compare)

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

• Belden Optometry LLC

  • Optometrist
  • Canton, OH
  • NPI 1972049716
  Medicare reassignment Care Compare group NPD
• Westgate Optometry LLC

  • Optometrist
  • Fairview Park, OH
  • NPI 1356749683
  Medicare reassignment Care Compare group NPD
• Summit Family Vision LLC

  • Optometrist
  • Fairlawn, OH
  • NPI 1962065672
  Medicare reassignment Care Compare group
• Dr. Richard E. Hults & Assoc., Inc.

  • Optometrist
  • Fairview Park, OH
  • NPI 1548482185
  Medicare reassignment NPD
• Dr. Richard E Hults and Associates, Inc.

  • Optometrist
  • Elyria, OH
  • NPI 1003226820
  NPD

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1801588967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3580 WESTGATE",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441261300",
            "telephone_number": "440-356-4020",
            "fax_number": "440-356-4022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 WESTGATE",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441261300",
            "telephone_number": "440-356-4020",
            "fax_number": "440-356-4022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3265 W Market St",
            "address_purpose": "LOCATION",
            "city": "Fairlawn",
            "state": "OH",
            "postal_code": "443333337",
            "country_code": "US",
            "telephone_number": "330-252-7457",
            "fax_number": "330-836-2985",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4157 Belden Village Mall",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447182501",
            "country_code": "US",
            "telephone_number": "330-494-4140",
            "fax_number": "330-497-0778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4690 Midway Mall",
            "address_purpose": "LOCATION",
            "city": "Elyria",
            "state": "OH",
            "postal_code": "440352469",
            "country_code": "US",
            "telephone_number": "440-324-4557",
            "fax_number": "440-324-5078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EIDOM",
        "first_name": "MATTHEW",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-25",
        "last_updated": "2024-03-15",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.007165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Richard E. Hults & Assoc., Inc.
• Basem Droubi, M.D.
• Carly Dureiko, MSFS, RD, LD
• Nicolina Dzurnak
• Earl Gentile Hearing Services Inc.
• Jessica Sue Eidson, RN
• Anesah Elhaddi, M.D.
• John P Ellis, DPM
• Sarah Michelle Everett, PA-C
• Fairview Eye Center, Inc (The Eye Centers)

• Optometrist in Fairview Park, OH
• Providers in Fairview Park, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.