Individual provider Active NPI

Matthew Olson, OD

  • Optometrist
  • Mansfield, OH
National Provider Identifier
1821657198
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.006800 Issued in OH
Practice address
466 S Trimble Rd
Mansfield, OH 44906-3416
Phone
(419) 756-8000
Fax
(419) 756-2601
NPI assigned
Jun 11, 2019
Last updated
Apr 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6800 OH
Optometrist 152W00000X OPT.006800 OH Primary

Addresses

Primary practice location

466 S Trimble Rd
Mansfield, OH 44906-3416

Mailing address

466 S Trimble Rd
Mansfield, OH 44906-3416
Phone (419) 756-8000

Other identifiers 1

IdentifierTypeStateIssuer
0362050MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address molson@ohioeye.intellechartdirect.net

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
I20190725002127 OH Practitioner - Optometry 6507192796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Western University of Health Sciences College of Dental Med, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio Eye Optometric LLCGroup PAC ID 7012144876, 11 clinicians

Practice addresses (Care Compare)

466 S Trimble Rd
Mansfield, OH 44906-3416
Phone (419) 756-8000

Merit-based Incentive Payment System (MIPS)

Final score
94.15 of 100Reported as group
Quality
88.3
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6800OHMDOptometrist
OPT.006800OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Eye Optometric, LLC Optometrist CurrentSince Jun 1, 2019 Accepting new patients
Ohio Eye Optometric LLC Optometrist CurrentSince Jun 1, 2019 Accepting new patients
Ohio Eye Optometric, LLC Optometrist Past Accepting new patients

Locations

129 S Walnut St
Bucyrus, OH 44820
Phone (419) 560-4503

466 S Trimble Rd
Mansfield, OH 44906
Phone (419) 756-8000

58 W High St
Mount Gilead, OH 43338
Phone (419) 756-8000

38 Sandusky St
Plymouth, OH 44865
Phone (419) 687-6791

76 W Main St
Shelby, OH 44875
Phone (419) 347-1445

Interoperability endpoints

  • Direct secure messaging: molson@ohioeye.intellechartdirect.net

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, 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": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1821657198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "466 S TRIMBLE RD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449063416",
            "telephone_number": "419-756-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "466 S TRIMBLE RD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449063416",
            "telephone_number": "419-756-8000",
            "fax_number": "419-756-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-11",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6800",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.006800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0362050",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "molson@ohioeye.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "466 S Trimble Rd",
            "city": "Mansfield",
            "state": "OH",
            "country_code": "US",
            "postal_code": "449063416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

Verify at the official NPI Registry.