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MRS. ALEXZANDRA RUDINOFF ROTH OD
NPI 1053978361
Optometrist in Fremont, OH

Active since May 22, 2019PECOS EnrolledAccepts Medicare Assignment
75.56/100
CMS Quality Rating
2311 HAYES AVE, SUITE B, FREMONT, OH 43420(419) 334-8121(419) 332-9351 Get Directions Write a Review

NPPES record last updated: December 4, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 4, 2025, May 22, 2019 (2 updates tracked since 2019).

About Mrs. Alexzandra Rudinoff Roth Od NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. ALEXZANDRA RUDINOFF ROTH OD (NPI 1053978361) is an individual optometrist in Fremont, Ohio, licensed in Ohio (OPT.006777) and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Ohio State University - College Of Optometry (2019).

NPPES Registry Identity

NPI1053978361
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameMRS. ALEXZANDRA RUDINOFF ROTHCredential: OD
Location Address2311 HAYES AVE, SUITE BFremont, OH 43420-2634
Mailing Address2311 Hayes Ave, Suite BFremont, OH 43420-2634 · (419) 334-8121 · Fax (419) 332-9351
Phone(419) 334-8121
Fax(419) 332-9351
Sole ProprietorNo
Medical School CMSOhio State University - College Of OptometryGraduated 2019
Enumeration DateMay 22, 2019
Last NPPES UpdateDecember 4, 20252 updates tracked since enumeration
NPPES CertifiedDecember 4, 2025
✔ NPI 1053978361 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in OH · OPT.006777
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
2311 HAYES AVE, Fremont, OH 43420
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Other Names 1

Former Name (1)Ms. Alexzandra A Rudinoff

Secondary Practice Locations 2

Location 11002 Garden Lake PkwyToledo, OH 43614-2780 · Phone (419) 720-3937
Location 2622 Parkway DrFostoria, OH 44830-1573 · Phone (419) 435-3482

Other Identifiers 2

Medicaid0375568OH
OtherQ00246380OH · Ptan

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include MedMutual, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Alexzandra Rudinoff Roth Od is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3274860069
PECOS Enrollment IDI20190816002330
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
163 services158 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
90 services81 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
52 services52 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
42 services42 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
33 services31 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
22 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43420 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$68.07 typical visit price
range $17.10 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75.56/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40
Cost18.55

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JASON R KOLODZIEJCZYK O.D.
Optometrist
2311 HAYES AVE
FREMONT, OH 43420
Sandusky County (419) 334-8121
EYE CENTERS OF NORTHWEST OHIO LLC
Optometrist
2311 HAYES AVE, SUITE B
FREMONT, OH 43420
Sandusky County (419) 334-8121
STACY PASCH RELLINGER OD
Optometrist
2311 HAYES AVE
FREMONT, OH 43420
Sandusky County (419) 334-8121
EYE CENTERS OF NORTHWEST OHIO INC
Eyewear Supplier
2311 HAYES AVE
FREMONT, OH 43420
Sandusky County (419) 334-8121
GREGORY J DERODES O.D.
Optometrist
2311 HAYES AVE
FREMONT, OH 43420
Sandusky County (419) 334-8121

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alexzandra Roth's NPI number?

The NPI number for Alexzandra Roth is 1053978361. It was assigned to this individual provider in the NPPES registry on May 22, 2019. The provider is also known as Ms. Alexzandra A Rudinoff.

Where is Alexzandra Roth located?

Alexzandra Roth practices at 2311 Hayes Ave Suite B, Fremont, OH 43420. The listed phone number is (419) 334-8121.

What is Alexzandra Roth's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Alexzandra Roth enrolled in Medicare?

Yes. Alexzandra Roth is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Alexzandra Roth accept?

Health plans from MedMutual and Providence Health Plan list Alexzandra Roth as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Alexzandra Roth was last updated on December 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.