Tiffany Procaccini, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

5906 Issued in OH

Practice address

320 W Walton St
Willard, OH 44890-9133

Phone

(419) 933-2741

NPI assigned

Jul 14, 2009

Sex

Female

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 7

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

Medicare enrollment (NPD)

Enrolled

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.

• Willard Eye Care Inc

  • Optometrist
  • Willard, OH
  • NPI 1851823330

  OH, Optometrist

  Medicare reassignment NPD Authorized official
• Envision Icare, Inc

  • Optometrist
  • Bellevue, OH
  • NPI 1750534087
  NPD (past)
• Hookway Eye Care Inc

  • Corneal and Contact Management Optometrist
  • Willard, OH
  • NPI 1497871362
  NPD (past)
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  NPD (past)

Specialty

Optometry

Education

Ohio State University - College of Optometry, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1912136755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270",
            "city": "WILLARD",
            "state": "OH",
            "postal_code": "448900270",
            "telephone_number": "419-933-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W WALTON ST",
            "city": "WILLARD",
            "state": "OH",
            "postal_code": "448909133",
            "telephone_number": "419-933-2741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCACCINI",
        "first_name": "TIFFANY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-14",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1043330871",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "9292043",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2988521",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP PTAN",
            "identifier": "CG0387",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1912136755",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PTAN",
            "identifier": "H060602",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDCIARE PTAN",
            "identifier": "P01269559",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zachary Philbeck
• Phillip Keysor
• Meagan Ponchel, COTA/L
• Amelia Schrag Prack, M.D.
• Pristine Senior Living of Willard, LLC
• Misty Proffitt
• Rite Aid of Ohio Inc
• Dawn Rene Robinson, LPTA
• Jenny L Robinson, LPN
• Monica Marie Robinson, LPN

• All providers in Willard, OH
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; 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.