Individual provider Active NPI

Nathan Kaufman, O.D.

  • Optometrist
  • Sugarcreek, OH
National Provider Identifier
1811301179
Registry record updated Jun 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6289 Issued in OH
Practice address
232 Factory Street NE
Sugarcreek, OH 44681-9300
Phone
(330) 852-2512
Fax
(330) 852-7602
NPI assigned
Jun 16, 2014
Last updated
Jun 16, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6289 OH Primary

Addresses

Primary practice location

232 Factory Street NE
Sugarcreek, OH 44681-9300

Mailing address

PO Box 245
Sugarcreek, OH 44681-0245
Phone (330) 852-2512

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
I20140805001334 OH Practitioner - Optometry 6709003395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Insight Vision Care IncGroup PAC ID 0244302511, 7 clinicians

Practice addresses (Care Compare)

110 Andreas Dr NE
Suite a
Sugarcreek, OH 44681-7503
Phone (330) 852-2512

232 N Factory St
Sugarcreek, OH 44681-0245
Phone (330) 852-2512

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6289OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Vision Care, Inc. Optometrist CurrentSince Jun 12, 2014 Accepting new patients

Locations

110 Andreas Dr NE
#A
Sugarcreek, OH 44681
Phone (330) 852-2512

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": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402876800000",
    "number": "1811301179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 245",
            "city": "SUGARCREEK",
            "state": "OH",
            "postal_code": "446810245",
            "telephone_number": "330-852-2512",
            "fax_number": "330-852-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 FACTORY STREET NE",
            "city": "SUGARCREEK",
            "state": "OH",
            "postal_code": "446819300",
            "telephone_number": "330-852-2512",
            "fax_number": "330-852-7602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-16",
        "last_updated": "2014-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugarcreek, OH

Sources for this page

Verify at the official NPI Registry.