Darryl D Mathewson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3876 Issued in OH

Practice address

417 4TH St
Defiance, OH 43512-2605

Phone

(419) 782-9595

Fax

(419) 782-0876

NPI assigned

Oct 27, 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, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Vision Services LLCGroup PAC ID 0840244851, 2 clinicians

Practice addresses (Care Compare)

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.

• Professional Vision Services LLC

  • Optometrist
  • Defiance, OH
  • NPI 1528289659
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1952391278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 4TH ST",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435122605",
            "telephone_number": "419-782-9595",
            "fax_number": "419-782-0876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 4TH ST",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435122605",
            "telephone_number": "419-782-9595",
            "fax_number": "419-782-0876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEWSON",
        "first_name": "DARRYL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0645092",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINA-STAR FEDERAL",
            "identifier": "0189490001",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL INSURANCE PIN",
            "identifier": "3876",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS/BLUE SH",
            "identifier": "000000133472",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• April Elaine Manz, PTA
• Kaylee Marihugh
• Marion Vamc
• Bryna Marshall
• Monica Martinez
• Maumee Valley Guidance Center
• Maumee Valley Guidance Center
• Maumee Valley Guidance Center Inc
• Maumee Valley Guidance Center Inc.
• Maumee Valley Guidance Center,Inc

• Optometrist in Defiance, OH
• Providers in Defiance, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; 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.