Individual provider Active NPI

William R Rudy, OD

  • Optometrist
  • Kent, OH
National Provider Identifier
1972563047
Registry record updated Jan 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4310 Issued in OH
Practice address
2013 State Route 59
Kent, OH 44240-4113
Phone
(330) 678-0201
Fax
(330) 678-4272
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4310 OH Primary
Optometrist 152W00000X T305 OH

Addresses

Primary practice location

2013 State Route 59
Kent, OH 44240-4113

Mailing address

2013 State Route 59
Kent, OH 44240-4113
Phone (330) 678-0201

Other identifiers 1

IdentifierTypeStateIssuer
0239389MedicaidOH

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
I20061109000446 OH Practitioner - Optometry 0446258248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Ohio Eye Surgeons IncGroup PAC ID 3577537042, 32 clinicians

Practice addresses (Care Compare)

2013 State Route 59
Kent, OH 44240-4113
Phone (330) 678-0201

4277 Allen Rd
Stow, OH 44224-1053
Phone (330) 928-0201

Merit-based Incentive Payment System (MIPS)

Final score
85.48 of 100Reported as group
Quality
77.53
Promoting interoperability
96
Improvement activities
40
Cost
77.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4310OHMDOptometrist
T305OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Ohio Eye Surgeons, Inc. Optometrist CurrentSince Nov 1, 2006 Accepting new patients
Northeast Ohio Eye Surgeons, Inc. Optometrist Current Accepting new patients
Northeast Ohio Eye Surgeons, Inc. Optometrist CurrentSince Nov 1, 2006 Accepting new patients

Locations

4099 Embassy Pkwy
Akron, OH 44333
Phone (330) 835-1844

6880 W Snowville Rd
Ste 215
Brecksville, OH 44141
Phone (440) 526-1974

2013 State Route 59
Kent, OH 44240
Phone (330) 434-1185

4463 Weymouth Rd
Medina, OH 44256
Phone (330) 722-2150

4277 Allen Rd
Stow, OH 44224
Phone (330) 928-0201

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388707200000",
    "number": "1972563047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 STATE ROUTE 59",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442404113",
            "telephone_number": "330-678-0201",
            "fax_number": "330-678-4272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2013 STATE ROUTE 59",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442404113",
            "telephone_number": "330-678-0201",
            "fax_number": "330-678-4272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDY",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2014-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4310",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "T305",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0239389",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, OH

Sources for this page

Verify at the official NPI Registry.