Individual provider Active NPI

Bernadette Sipple, O.D.

  • Optometrist
  • Fairview Park, OH
National Provider Identifier
1821164310
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4469 Issued in OH
Practice address
3177 Westgate Mall
Fairview Park, OH 44126
Phone
(330) 697-4748
Fax
(866) 425-2239
NPI assigned
Nov 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 4469 OH
Optometrist 152W00000X 4469 OH Primary

Addresses

Primary practice location

3177 Westgate Mall
Fairview Park, OH 44126

Mailing address

PO Box 880
Hudson, OH 44236-5880
Phone (330) 697-4748

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
I20111229000670 OH Practitioner - Optometry 5991971665 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westgate Optometry LLCGroup PAC ID 0042539389, 2 clinicians

Practice addresses (Care Compare)

3580 Westgate
Fairview Park, OH 44126-1300
Phone (440) 356-4020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4469OHMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Richard E. Hults & Assoc., Inc. Optometrist CurrentSince Sep 1, 1993 Accepting new patients
Westgate Optometry LLC Optometrist CurrentSince Mar 16, 2015 Accepting new patients
Dr. Richard E Hults and Associates, Inc. Optometrist CurrentSince Sep 1, 1993 Accepting new patients

Locations

3580 Westgate
Fairview Park, OH 44126
Phone (440) 356-4020

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1821164310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 880",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442365880",
            "telephone_number": "330-697-4748",
            "fax_number": "866-425-2239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3177 WESTGATE MALL",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "44126",
            "telephone_number": "330-697-4748",
            "fax_number": "866-425-2239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIPPLE",
        "first_name": "BERNADETTE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OH",
            "license": "4469",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairview Park, OH

Sources for this page

Verify at the official NPI Registry.