Individual provider Active NPI

Amanda Lee Junkin, O.D.

  • Optometrist
  • Beachwood, OH
National Provider Identifier
1841699618
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6468T3385 Issued in OH
Practice address
3733 Park East Dr Ste 104
Beachwood, OH 44122-4334
Phone
(216) 839-0200
Fax
(216) 839-0808
NPI assigned
Aug 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 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 6468T3385 OH Primary

Addresses

Primary practice location

3733 Park East Dr Ste 104
Beachwood, OH 44122-4334

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

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
I20181003002210 OH Practitioner - Optometry 6002168986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Ohio, LLCGroup PAC ID 7719211010, 72 clinicians

Practice addresses (Care Compare)

5992 Darrow Rd
Hudson, OH 44236-3804
Phone (330) 650-9599

8254 Mayberry SQ N
Sylvania, OH 43560-9457
Phone (419) 885-5300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6468T3385OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Ohio, LLC Optometrist CurrentSince Feb 3, 2020 Accepting new patients
Myeyedr Optometry of Ohio, LLC Optometrist CurrentSince Feb 3, 2020 Accepting new patients
Myeyedr Optometry of Ohio, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist Past Accepting new patients
SVS Vision Inc Optometrist PastSince Aug 31, 2018 Accepting new patients

Locations

3733 Park East Dr
Ste 104
Beachwood, OH 44122
Phone (216) 839-0200

5992 Darrow Rd
Hudson, OH 44236
Phone (216) 839-0200

8254 Mayberry Sq N
Sylvania, OH 43560
Phone (419) 885-5300

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 5

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": "1408320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1841699618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3733 PARK EAST DR STE 104",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224334",
            "telephone_number": "216-839-0200",
            "fax_number": "216-839-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNKIN",
        "first_name": "AMANDA",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-18",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6468T3385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.