Individual provider Active NPI

Geral Mesadieu, O.D.

  • Optometrist
  • Newark, OH
National Provider Identifier
1902114036
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6351 Issued in OH
Practice address
1315 N 21St St
Newark, OH 43055-3090
Phone
(740) 364-9130
NPI assigned
Sep 23, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6351 OH Primary

Addresses

Primary practice location

1315 N 21St St
Newark, OH 43055-3090

Mailing address

6191 Wealthy LN
Dublin, OH 43016-7812
Phone (954) 594-6831

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
I20170929002374 OH Practitioner - Optometry 5092099614 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6351OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family First Vision Care, LLC Optometrist CurrentSince Aug 1, 2017 Accepting new patients
Orchard Eyecare Optometrist CurrentSince Oct 9, 2022 Accepting new patients

Locations

3948 Morse Xing
Columbus, OH 43219
Phone (614) 475-5240

5043 Tuttle Crossing Blvd
Ste 238
Dublin, OH 43016
Phone (614) 766-6638

316 S Hamilton Rd
Gahanna, OH 43230

368 S Hamilton Rd
Gahanna, OH 43230
Phone (614) 478-5030

1315 N 21st St
Newark, OH 43055
Phone (740) 364-9114

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": "1285200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1902114036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6191 WEALTHY LN",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430167812",
            "telephone_number": "954-594-6831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 N 21ST ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430553090",
            "telephone_number": "740-364-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESADIEU",
        "first_name": "GERAL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-23",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.