Individual provider Active NPI

Scott C Kriessler, O.D.

  • Optometrist
  • Willoughby, OH
National Provider Identifier
1902854136
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4657 T1432 Issued in OH
Practice address
5900 Som Center Rd
Suite 19
Willoughby, OH 44094-3086
Phone
(440) 585-2020
Fax
(440) 585-2044
NPI assigned
May 4, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4657 T1432 OH Primary

Addresses

Primary practice location

5900 Som Center Rd
Suite 19
Willoughby, OH 44094-3086

Mailing address

5900 Som Center Rd
Suite 19
Willoughby, OH 44094-3086
Phone (440) 585-2020

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
I20100125000550 OH Practitioner - Optometry 2860382801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
For Your Eyes Only, IncGroup PAC ID 3971493917, 3 clinicians

Practice addresses (Care Compare)

5900 Som Ctr Rd
Suite 19
Willoughby, OH 44094-3044
Phone (440) 585-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4657 T1432OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
For Your Eyes Only, Inc Optometrist CurrentSince Mar 16, 2004 Accepting new patients
For Your Eyes Only, Inc. Optometrist PastSince Jul 25, 2021 Accepting new patients
Northern Ohio Eye Consultants Inc Optometrist Past Accepting new patients

Locations

21771 Lake Shore Blvd
Euclid, OH 44123
Phone (216) 261-5050

5900 Som Center Rd
Willoughby, OH 44094
Phone (440) 479-5497

5900 Som Center Rd
Ste 19
Willoughby, OH 44094
Phone (440) 585-2020

Interoperability endpoints

  • Direct secure messaging: drscottk@direct.revolutionehr.com

Organizations & group practices 3

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1902854136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 SOM CENTER RD",
            "address_2": "SUITE 19",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440943086",
            "telephone_number": "440-585-2020",
            "fax_number": "440-585-2044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 SOM CENTER RD",
            "address_2": "SUITE 19",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440943086",
            "telephone_number": "440-585-2020",
            "fax_number": "440-585-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIESSLER",
        "first_name": "SCOTT",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4657  T1432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

Verify at the official NPI Registry.