GRAND LAKE EYECARE LLC
NPI 1548301690
Optometrist in Celina, OH
NPI Status: Active since February 10, 2007
Contact Information
1025 GRAND LAKE RD
CELINA, OH
ZIP 45822
Phone: (419) 586-3151
Fax: (419) 586-1059
- Organization
- Optometrist
- Accepts Insurance
- Medicare Supplier
- Accepts Medicare Approved Payment
- CLIA Number: 36D2310108
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-26-2026
About GRAND LAKE EYECARE LLC
This page provides the complete NPI Profile along with additional information for Grand Lake Eyecare Llc, a provider established in Celina, Ohio operating as a Optometrist. The healthcare provider is registered in the NPI registry with number 1548301690 assigned on February 2007. The practitioner's primary taxonomy code is 152W00000X. The provider is registered as an organization and their NPI record was last updated 18 years ago. The authorized official of this NPI record is Dr. Kenneth J Sandker Od (Partner)
- NPI
- 1548301690
- Provider Name
- GRAND LAKE EYECARE LLC
- Entity Type
- Organization
- Location Address
- 1025 GRAND LAKE RD CELINA, OH 45822
- Location Phone
- (419) 586-3151
- Location Fax
- (419) 586-1059
- Mailing Address
- PO BOX 377 CELINA, OH 45822
- Mailing Phone
- (419) 586-3151
- Mailing Fax
- (419) 586-1059
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-10-2007
- Last Update Date
- 02-05-2008
- Code Navigator
Grand Lake Eyecare Llc is a medicare supplier with PTAN 20576435 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Prosthetic Lenses: Conventional Eyeglasses or Prosthetic Lenses: Conventional Contact Lenses or Prosthetic Lenses: Prosthetics Cataract Lenses.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Optometrist
- Taxonomy Code
- 152W00000X
- Type
- Eye and Vision Services Providers
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | |
| 2 | 332H00000X | Suppliers | Eyewear Supplier |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Pathway 10600 ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway 10600 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway 8500 for HSA - HMO
- Anthem Gold Pathway 2000 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Bronze Pathway 6000 ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Silver Pathway 5000 ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway 4000 ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway 4000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway 5500 for HSA - HMO
- Anthem Silver Pathway 6000 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
- BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 9349941 | MEDICARE PIN (08) | OH | |
| 5661870001 | MEDICARE NSC (07) | OH |
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20576435
- Accepts Medicare Assignment
- YES
- Specialities List
- Optometrist.
- Competitive Bidding
- NO
Supplies List
- Prosthetic Lenses: Conventional Eyeglasses - Conventional Eyeglasses
- Prosthetic Lenses: Conventional Contact Lenses - Conventional Contact Lenses
- Prosthetic Lenses: Prosthetics Cataract Lenses - Cataract Eyeglasses
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 36D2310108
- Facility Type
- Physician Office
- Certificate Effective Date
- August 27, 2024
- Certificate Expiration Date
- August 26, 2026
- Laboratory Director
- DR. ALEXANDER C. MAST
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Grand Lake Eyecare Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for GRAND LAKE EYECARE LLC
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1548301690, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 70. The final step is to find the difference between that total and the next multiple of ten (70 - 70 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 70 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 8 providers are registered at the same or a nearby location.
CELINA, OH 45822
CELINA, OH 45822
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1548301690, enumerated as an "organization" on February 10, 2007.
The provider is located at 1025 GRAND LAKE RD CELINA, OH 45822 and the phone number is (419) 586-3151.
Optometrist with taxonomy code 152W00000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, BlueCross. Please consult your insurance carrier or call the provider to verify.
