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GLANDORF VISION GROUP INC.
NPI 1457406696
Optometrist in Glandorf, OH

Active since January 25, 2007CLIA 36D2061363 · Waiver
102 DR THATYE DRIVE, GLANDORF, OH 45848(419) 538-6273(419) 538-7273 Get Directions Write a Review

NPPES record last updated: July 14, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 14, 2021, Nov 16, 2020 (2 updates tracked since 2020).

About Glandorf Vision Group Inc. NPPES

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

GLANDORF VISION GROUP INC. (NPI 1457406696) is a healthcare organization registered as an optometrist in Glandorf, Ohio and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through June 25, 2027 and lists Adria Petrick, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1457406696
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameGLANDORF VISION GROUP INC.
Location Address102 DR THATYE DRIVEGlandorf, OH 45848-0020
Mailing AddressPo Box 20Glandorf, OH 45848-0020 · (419) 538-6273 · Fax (419) 538-7273
Phone(419) 538-6273
Fax(419) 538-7273
Organization SubpartNo
Authorized OfficialAdria PetrickOffice Manager · (419) 538-6273
Enumeration DateJanuary 25, 2007
Last NPPES UpdateJuly 14, 20212 updates tracked since enumeration
NPPES CertifiedJuly 14, 2021
✔ NPI 1457406696 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 · 2916
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.
102 DR THATYE DRIVE, Glandorf, OH 45848
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Other Identifiers 4

Medicaid0179266OH
Other000000140764OH · Anthem Bcbs
Other30140272400OH · Bwc
Other410037333OH · Railroad Medicare

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Glandorf Vision Group Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Glandorf Vision Group Inc., which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Abigail Hilvers, OD
Optometry
NPI 1679468417
102 DR THATYE DRIVE
Glandorf, OH 45848
(419) 538-6273
✔ PECOS✔ Accepts MedicareSame address
Jesselyn Michaud, O.D.
Optometry
NPI 1437531050
102 DOCTOR THATYE DRIVE
Glandorf, OH 45848
(419) 538-6273
✔ PECOS✔ Accepts Medicare5.8 mi
Lindsey Kremer, OD
Optometry
NPI 1396115606
2765 FORT AMANDA RD
Lima, OH 45805
(419) 228-3937
✔ PECOS✔ Accepts Medicare22 mi

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D2061363

Glandorf Vision Group, Inc · Glandorf, OH
Active · expires Jun 25, 2027
CLIA Number36D2061363
Laboratory TypePhysician Office
Certificate Effective DateJune 26, 2025
Certificate Expiration DateJune 25, 2027
Laboratory DirectorJesselyn Michaud
Laboratory Phone(419) 538-6273
Laboratory LocationGlandorf Vision Group, Inc102 Doctor Thatye Dr, Glandorf, OH 45848
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Glandorf Vision Group Inc.'s NPI number?

The NPI number for Glandorf Vision Group Inc. is 1457406696. It was assigned to this organization in the NPPES registry on January 25, 2007.

Where is Glandorf Vision Group Inc. located?

Glandorf Vision Group Inc. is located at 102 Dr Thatye Drive, Glandorf, OH 45848. The listed phone number is (419) 538-6273.

What is Glandorf Vision Group Inc.'s specialty?

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

Is Glandorf Vision Group Inc. enrolled in Medicare?

Yes. Glandorf Vision Group Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Glandorf Vision Group Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Optometry, reassign their Medicare billing to Glandorf Vision Group Inc.. 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. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Glandorf Vision Group Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2061363) is associated with this NPI, valid through June 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Glandorf Vision Group Inc. accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and BlueCross BlueShield of Tennessee list Glandorf Vision Group Inc. 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 Glandorf Vision Group Inc. was last updated on July 14, 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.