ETHAN T MENGLE OD
NPI 1417449174
Optometrist in Medina, OH

Q: What is Ethan Mengle's NPI number?

The NPI number for Ethan Mengle is 1417449174. It was assigned to this individual provider in the NPPES registry on May 30, 2018.

Q: What is Ethan Mengle's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Ethan Mengle was last updated on June 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since May 30, 2018PECOS Enrolled

409 N COURT ST, MEDINA, OH 44256(330) 725-4680(330) 633-7165 Get Directions Write a Review

NPPES record last updated: June 8, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Ethan T Mengle Od NPPES

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

ETHAN T MENGLE OD (NPI 1417449174) is an individual optometrist in Medina, Ohio, licensed in Ohio (OPT.006684) and active in the NPI registry since May 2018. He is enrolled in Medicare PECOS and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1417449174

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameETHAN T MENGLECredential: OD

Location Address409 N COURT STMedina, OH 44256-1869

Mailing AddressPo Box 207170Dallas, TX 75320-7173 · (636) 200-4393 · Fax (636) 527-0766

Phone(330) 725-4680

Fax(330) 633-7165

Sole ProprietorNo

Enumeration DateMay 30, 2018

Last NPPES UpdateJune 8, 2021

NPPES CertifiedJune 8, 2021

✔ NPI 1417449174 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.006684

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.

409 N COURT ST, Medina, OH 44256

Open in Google Maps ↗

Secondary Practice Locations 3

Location 11558 Akron Peninsula RdAkron, OH 44313-5154 · Phone (330) 922-4040

Location 25697 Darrow RdHudson, OH 44236-4013 · Phone (330) 650-0919

Location 31155 State Route 303Streetsboro, OH 44241-3969 · Phone (330) 422-2020 · Fax (330) 422-0316

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ethan T Mengle Od 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 Ethan Mengle reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Clarkson Optometry Midwest Inc

Same address

Optometrist

409 N COURT ST
Medina, OH 44256

Reassigned Medicare billing, Ohio enrollment
114 clinicians in this Medicare group

NPI 1114507951 (330) 725-4680

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 44256 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 4

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

CLARKSON OPTOMETRY MIDWEST INC

Optometrist

409 N COURT ST
MEDINA, OH 44256

Medina County (330) 725-4680

ANN MARIE CATER

Optometrist

409 N COURT ST
MEDINA, OH 44256

Medina County (330) 725-4680

DR. JONATHAN MARK SCHONFELD O.D.

Optometrist

409 N COURT ST
MEDINA, OH 44256

Medina County (330) 725-4680

AARON TYLER PALMERI OD

Optometrist

409 N COURT ST
MEDINA, OH 44256

Medina County (330) 725-4680

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 Ethan Mengle's NPI number?

The NPI number for Ethan Mengle is 1417449174. It was assigned to this individual provider in the NPPES registry on May 30, 2018.

Where is Ethan Mengle located?

Ethan Mengle practices at 409 N Court St, Medina, OH 44256. The listed phone number is (330) 725-4680.

What is Ethan Mengle's specialty?

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

Is Ethan Mengle enrolled in Medicare?

Yes. Ethan Mengle is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ethan Mengle's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ethan Mengle reassigns Medicare benefits to Clarkson Optometry Midwest Inc (Medina, 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 Ethan Mengle's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ethan Mengle accept?

Health plans from CareSource list Ethan Mengle 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 Ethan Mengle was last updated on June 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.