CLEVELAND VISION CENTER
NPI 1376272369
Optometrist in Cleveland, OK

Q: What is Kedzymac Enterprises, LLC's NPI number?

The NPI number for Kedzymac Enterprises, LLC is 1376272369. It was assigned to this organization in the NPPES registry on June 6, 2022. The provider is doing business as Cleveland Vision Center.

Q: What is Kedzymac Enterprises, LLC's specialty?

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

Active since June 06, 2022

107 S BROADWAY ST, CLEVELAND, OK 74020(918) 385-2245 Get Directions Write a Review

NPPES record last updated: April 19, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 19, 2024, Jun 6, 2022 (2 updates tracked since 2022).

On this page

About Cleveland Vision Center NPPES

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

CLEVELAND VISION CENTER (NPI 1376272369) is a healthcare organization registered as an optometrist in Cleveland, Oklahoma and active in the NPI registry since June 2022. The organization lists Lisa Kedzuf-mcginnis, Optometrist, as its authorized official.

NPPES Registry Identity

NPI1376272369

Entity TypeOrganization

Primary Taxonomy152W00000X

Legal Business NameKEDZYMAC ENTERPRISES, LLC

Location Address107 S BROADWAY STCleveland, OK 74020-4614

Mailing Address9318 Scarlet Oak DrSand Springs, OK 74063-3901

Phone(918) 385-2245

Organization SubpartNo

Authorized OfficialLisa Kedzuf-mcginnisOptometrist · (918) 520-4344

Enumeration DateJune 6, 2022

Last NPPES UpdateApril 19, 20242 updates tracked since enumeration

NPPES CertifiedJune 14, 2022

✔ NPI 1376272369 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

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.

107 S BROADWAY ST, Cleveland, OK 74020

Open in Google Maps ↗

Other Names 1

Doing Business AsCleveland Vision Center

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Cleveland Vision Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Cleveland Vision Center, which bills Medicare for the services this clinician delivers.

Clinician (1)

Lisa Kedzuf-Mcginnis, O.D.

Optometry

NPI 1134216609

107 S BROADWAY ST
Cleveland, OK 74020

(918) 358-2245

✔ PECOS✔ Accepts MedicareSame address

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

Medical Equipment Supplier Medicare DMEPOS 2

Medicare supplier enrollment and the product categories Cleveland Vision Center carries, from the Medicare DMEPOS supplier directory.

Cleveland Vision Center

DMEPOS supplier · Cleveland, OKOperated by Kedzymac Enterprises LLC

✔

Accepts Medicare assignment

Cleveland Vision Center agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)34357268

Medicare Participant SinceJune 29, 2022

Supplier Location107 S Broadway StCleveland, OK 74020

Phone(918) 358-2245

Supplier Specialties

Optometrist

Medicare Product Categories

Prosthetic Lenses: Conventional Eyeglasses

Conventional Eyeglasses

Prosthetic Lenses: Conventional Contact Lenses

Conventional Contact Lenses

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

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 Kedzymac Enterprises, LLC's NPI number?

The NPI number for Kedzymac Enterprises, LLC is 1376272369. It was assigned to this organization in the NPPES registry on June 6, 2022. The provider is doing business as Cleveland Vision Center.

Where is Kedzymac Enterprises, LLC located?

Kedzymac Enterprises, LLC is located at 107 S Broadway St, Cleveland, OK 74020. The listed phone number is (918) 385-2245.

What is Kedzymac Enterprises, LLC's specialty?

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

Is Kedzymac Enterprises, LLC enrolled in Medicare?

Yes. Kedzymac Enterprises, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kedzymac Enterprises, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Kedzymac Enterprises, LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Kedzymac Enterprises, LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Cleveland Vision Center accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

When was this NPI record last updated?

The NPPES record for Kedzymac Enterprises, LLC was last updated on April 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.