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DR. SUE ELLEN VAN DOOTINGH O.D.
NPI 1366518045
Optometrist in Port Clinton, OH

Active since November 27, 2006PECOS Enrolled
820 JEFFERSON ST, PORT CLINTON, OH 43452(419) 732-2828 Get Directions Write a Review

NPPES record last updated: July 30, 2009. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Sue Ellen Van Dootingh O.d. NPPES

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

DR. SUE ELLEN VAN DOOTINGH O.D. (NPI 1366518045) is an individual optometrist in Port Clinton, Ohio, licensed in Ohio (3643) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1366518045
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameDR. SUE ELLEN VAN DOOTINGHCredential: O.D.
Location Address820 JEFFERSON STPort Clinton, OH 43452-2416
Mailing Address820 Jefferson StPort Clinton, OH 43452-2416 · (419) 732-2828
Phone(419) 732-2828
Sole ProprietorYes
Enumeration DateNovember 27, 2006
Last NPPES UpdateJuly 30, 2009
✔ NPI 1366518045 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 · 3643
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.
820 JEFFERSON ST, Port Clinton, OH 43452
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Other Identifiers 3

Medicaid0629387OH
Medicare UPINT48285
Medicare PIN0574912OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Sue Ellen Van Dootingh O.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Sue Van Dootingh reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Madison Eye Care Of Port Clinton LLC
Same address
Optometrist
820 JEFFERSON ST
Port Clinton, OH 43452
  • Reassigned Medicare billing, Ohio enrollment
  • 5 clinicians in this Medicare group
NPI 1427748243 (419) 732-2828

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43452 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.

Other Providers at the Same Location NPPES 2

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

MADISON EYE CARE OF PORT CLINTON LLC
Optometrist
820 JEFFERSON ST
PORT CLINTON, OH 43452
Ottawa County (419) 732-2828
SUE E. VAN DOOTINGH OD
Durable Medical Equipment & Medical Supplies
820 JEFFERSON ST
PORT CLINTON, OH 43452
Ottawa County (419) 732-2828

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 Sue Van Dootingh's NPI number?

The NPI number for Sue Van Dootingh is 1366518045. It was assigned to this individual provider in the NPPES registry on November 27, 2006.

Where is Sue Van Dootingh located?

Sue Van Dootingh practices at 820 Jefferson St, Port Clinton, OH 43452. The listed phone number is (419) 732-2828.

What is Sue Van Dootingh's specialty?

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

Is Sue Van Dootingh enrolled in Medicare?

Yes. Sue Van Dootingh is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Sue Van Dootingh's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sue Van Dootingh reassigns Medicare benefits to Madison Eye Care Of Port Clinton LLC (Port Clinton, OH). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sue Van Dootingh's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sue Van Dootingh accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and CareSource list Sue Van Dootingh 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 Sue Van Dootingh was last updated on July 30, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years 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.