Organization Active NPI

Daniel J. Mayer, M.D. Inc

  • Ophthalmology Physician
  • Medina, OH
National Provider Identifier
1942489620
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
053557 Issued in OH
Legal business name
DANIEL J. MAYER, M.D. INC
Practice address
4067 N Jefferson St
Medina, OH 44256-5622
Phone
(330) 725-4174
Fax
(330) 725-4080
NPI assigned
Oct 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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

Authorized official

Name
Janet Mayer
Title
Manager
Phone
(330) 725-4174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 053557 OH Primary

Addresses

Primary practice location

4067 N Jefferson St
Medina, OH 44256-5622

Mailing address

4067 N Jefferson St
Medina, OH 44256-5622
Phone (330) 725-4174

Other identifiers 3

IdentifierTypeStateIssuer
0628128MedicaidOH
CN7360OtherOHRETIRED RAILROAD MEDICARE
000000029208OtherOHBCBS

National Provider Directory

National Provider Directory

Locations

4067 N Jefferson St
Medina, OH 44256
Phone (330) 725-4174

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1942489620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4067 N JEFFERSON ST",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565622",
            "telephone_number": "330-725-4174",
            "fax_number": "330-725-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4067 N JEFFERSON ST",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565622",
            "telephone_number": "330-725-4174",
            "fax_number": "330-725-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL J. MAYER, M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-30",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "MAYER",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "330-725-4174"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "053557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0628128",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RETIRED RAILROAD MEDICARE",
            "identifier": "CN7360",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000029208",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.