Individual provider Active NPI

Lindsay M Dues, OD

  • Optometrist
  • Celina, OH
National Provider Identifier
1861747503
Registry record updated Feb 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6117 Issued in OH
Practice address
1025 Grand Lake Rd
Celina, OH 45822-1309
Phone
(419) 586-3151
Fax
(419) 586-1059
NPI assigned
Jul 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6117 OH Primary

Addresses

Primary practice location

1025 Grand Lake Rd
Celina, OH 45822-1309

Mailing address

P.O. Box 377
1025 Grand Lake Rd
Celina, OH 45822-1309
Phone (419) 586-3151

Other identifiers 1

IdentifierTypeStateIssuer
0074229MedicaidOH

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
I20120925000827 OH Practitioner - Optometry 1850540493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Lake Eyecare LLCGroup PAC ID 8527016278, 4 clinicians

Practice addresses (Care Compare)

2024 Holiday Dr
Celina, OH 45822-8344
Phone (419) 586-3151

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6117OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Lake Eyecare LLC Optometrist CurrentSince Jul 12, 2012 Accepting new patients
Grand Lake Eyecare, LLC Optometrist CurrentSince Jul 12, 2012 Accepting new patients

Locations

1025 Grand Lake Rd
Celina, OH 45822
Phone (419) 586-3151

2024 Holiday Dr
Celina, OH 45822
Phone (419) 586-3151

Interoperability endpoints

  • Direct secure messaging: lindsay.dues@direct.revolutionehr.com

Organizations & group practices 2

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": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423785600000",
    "number": "1861747503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 377",
            "address_2": "1025 GRAND LAKE RD",
            "city": "CELINA",
            "state": "OH",
            "postal_code": "458221309",
            "telephone_number": "419-586-3151",
            "fax_number": "419-586-1059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 GRAND LAKE RD",
            "city": "CELINA",
            "state": "OH",
            "postal_code": "458221309",
            "telephone_number": "419-586-3151",
            "fax_number": "419-586-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUES",
        "first_name": "LINDSAY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-18",
        "last_updated": "2015-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0074229",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Celina, OH

Sources for this page

Verify at the official NPI Registry.