GRAND LAKE EYECARE LLC

Q: What is Grand Lake Eyecare LLC's NPI number?

The NPI number for Grand Lake Eyecare LLC is 1548301690. It was assigned to this organization in the NPPES registry on February 10, 2007.

Q: What is Grand Lake Eyecare LLC's specialty?

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

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About Grand Lake Eyecare Llc NPPES

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

GRAND LAKE EYECARE LLC (NPI 1548301690) is a healthcare organization registered as an optometrist in Celina, Ohio and active in the NPI registry since February 2007. The organization lists Kenneth J Sandker, Partner, as its authorized official.

NPPES Registry Identity

NPI1548301690

Entity TypeOrganization

Primary Taxonomy152W00000X

Legal Business NameGRAND LAKE EYECARE LLC

Location Address1025 GRAND LAKE RDCelina, OH 45822-1309

Mailing AddressPo Box 377Celina, OH 45822-0377 · (419) 586-3151 · Fax (419) 586-1059

Phone(419) 586-3151

Fax(419) 586-1059

Organization SubpartNo

Authorized OfficialKenneth J SandkerPartner · (419) 586-3151

Enumeration DateFebruary 10, 2007

Last NPPES UpdateFebruary 5, 2008

✔ NPI 1548301690 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X

Also ListedEyewear SupplierTaxonomy 332H00000X

1025 GRAND LAKE RD, Celina, OH 45822

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Other Identifiers 2

Medicare PIN9349941OH

Medicare NSC5661870001OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BlueCross BlueShield of Tennessee.Insurance ›

Medical Equipment Supplier Medicare DMEPOS 3

Medicare supplier enrollment and the product categories Grand Lake Eyecare LLC carries, from the Medicare DMEPOS supplier directory.

DMEPOS supplier · Celina, OH

✔

Accepts Medicare assignment

Grand Lake Eyecare LLC 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)20576435

Medicare Participant SinceDecember 13, 2005

Supplier Location2024 Holiday DrCelina, OH 45822

Phone(419) 586-3151

Supplier Specialties

Optometrist

Medicare Product Categories

Prosthetic Lenses: Conventional Eyeglasses

Conventional Eyeglasses

Prosthetic Lenses: Conventional Contact Lenses

Conventional Contact Lenses

Prosthetic Lenses: Prosthetics Cataract Lenses

Cataract Eyeglasses

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

Other Providers at the Same Location NPPES 8

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

DR. KENNETH J SANDKER OD

Optometrist