Individual provider Active NPI

Michele A Schlagheck III, O.D.

  • Optometrist
  • Toledo, OH
National Provider Identifier
1881666295
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4456T1112 Issued in OH
Practice address
2865 N Reynolds Rd
Suite 170
Toledo, OH 43615-2068
Phone
(419) 578-2020
Fax
(419) 539-6323
NPI assigned
Feb 2, 2006
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4456T1112 OH Primary

Addresses

Primary practice location

2865 N Reynolds Rd
Suite 170
Toledo, OH 43615-2068

Mailing address

2865 N Reynolds Rd
Suite 170
Toledo, OH 43615-2068
Phone (419) 578-2020

Other identifiers 6

IdentifierTypeStateIssuer
0936563MedicaidOH
4634574OtherOHAETNA
000000121697OtherOHANTHEM
03099OtherOHPARAMOUNT
2201071OtherOHUNITED HEALTH CARE
1183130001OtherOHADMINASTAR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mschlagheck221046@epicdirect.promedica.org

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
I20060426000708 OH Practitioner - Optometry 8820008402 Reassigns benefits to 1 organization

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
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

2865 N Reynolds Rd
BLDG a
Toledo, OH 43615-2100
Phone (419) 578-7200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4456T1112OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians Optometrist CurrentSince Jul 1, 2021 Accepting new patients
Promedica Central Physicians CurrentSince Jul 1, 2021 Accepting new patients

Locations

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

2865 N Reynolds Rd
Bldg A
Toledo, OH 43615
Phone (419) 578-4200

Interoperability endpoints

  • Direct secure messaging: mschlagheck221046@direct.promedica.org

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, 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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1881666295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 N REYNOLDS RD",
            "address_2": "SUITE 170",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436152068",
            "telephone_number": "419-578-2020",
            "fax_number": "419-539-6323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 N REYNOLDS RD",
            "address_2": "SUITE 170",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436152068",
            "telephone_number": "419-578-2020",
            "fax_number": "419-539-6323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLAGHECK",
        "first_name": "MICHELE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4456T1112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0936563",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4634574",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000121697",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT",
            "identifier": "03099",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2201071",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINASTAR",
            "identifier": "1183130001",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mschlagheck221046@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.