Bruce P Mathie, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4803 Issued in OH

Practice address

4865 Frank Ave NW
North Canton, OH 44720-7425

Phone

(330) 494-1710

Fax

(330) 494-5815

NPI assigned

Nov 2, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Specialty

Optometry

Education

Ohio State University - College of Optometry, 1992

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)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

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.

• Bruce P Mathie

  • Optometrist
  • Louisville, OH
  • NPI 1497934764
  Medicare reassignment NPD Authorized official
• Myeyedr Optometry of Ohio, LLC

  • Optometrist
  • Dayton, OH
  • NPI 1902365448
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Ohio, LLC

  • Optometrist
  • North Canton, OH
  • NPI 1164024600
  NPD
• Myeyedr Optometry of Ohio, LLC

  • Optometrist
  • Warren, OH
  • NPI 1720970981
  NPD
• Family Vision Care of Alliance, Inc.

  • Optometrist
  • Alliance, OH
  • NPI 1609924398
  NPD (past)
• Fisher Foods Marketing Inc

  • Eyewear Supplier
  • Massillon, OH
  • NPI 1750441135
  NPD (past)
• Universal Medical Administration

  • Podiatrist
  • Cleveland, OH
  • NPI 1669412201
  NPD (past)
• Myeyedr Optometry of Virginia, PLLC

  • Optometrist
  • Chesapeake, VA
  • NPI 1669820304
  NPD (past)

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1881685667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 W MAIN ST",
            "city": "LOUISVILLE",
            "state": "OH",
            "postal_code": "446412310",
            "telephone_number": "330-875-4320",
            "fax_number": "330-875-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4865 FRANK AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207425",
            "telephone_number": "330-494-1710",
            "fax_number": "330-494-5815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIE",
        "first_name": "BRUCE",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2020-12-10",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "000000223574",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2039127",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "OH4803",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2708610",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mastracco Foot & Ankle LTD
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• Jenna Matheson, APRN
• James Mathews, LPTA
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• Max Medical Solutions LLC
• Kathryn Maximovich
• Heather R Maxwell, COTA/L

• Optometrist in North Canton, OH
• Providers in North Canton, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.