Individual provider Active NPI

Craig Charles McSurdy, O.D.

  • Optometrist
  • Columbus, OH
National Provider Identifier
1962551002
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4215 T1087 Issued in OH
Practice address
2066 W Henderson Rd
Suite 104
Columbus, OH 43220-2452
Phone
(614) 457-2081
Fax
(614) 457-6021
NPI assigned
Jan 9, 2007
Last updated
Nov 2, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4215 T1087 OH Primary

Addresses

Primary practice location

2066 W Henderson Rd
Suite 104
Columbus, OH 43220-2452

Mailing address

2066 W Henderson Rd
Suite 104
Columbus, OH 43220-2452
Phone (614) 457-2081

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
I20040129000997 OH Practitioner - Optometry 7618870395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2066 Henderson Rd
Suite 104
Columbus, OH 43220-2452
Phone (614) 457-2081

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4215 T1087OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
J. Terebuh MD Inc Optometrist Past Accepting new patients
Cole Vision Corporation Past Accepting new patients
Luxottica Retail North America Inc Past Accepting new patients

Organizations & group practices 4

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320192000000",
    "number": "1962551002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2066 W HENDERSON RD",
            "address_2": "SUITE 104",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202452",
            "telephone_number": "614-457-2081",
            "fax_number": "614-457-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2066 W HENDERSON RD",
            "address_2": "SUITE 104",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202452",
            "telephone_number": "614-457-2081",
            "fax_number": "614-457-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCSURDY",
        "first_name": "CRAIG",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2011-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4215 T1087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.