| Trillium Vision Care Of New Lexington, Llc | |
|
391 Lincoln Park Dr, New Lexington, OH 43764-1080 | |
| (740) 342-1784 | |
| (740) 342-1791 |
| Full Name | Trillium Vision Care Of New Lexington, Llc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 391 Lincoln Park Dr, New Lexington, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497357081 | NPI | - | NPPES |
| 0425236 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Douglas J Ryen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1174698245 PECOS PAC ID: 2567364904 Enrollment ID: I20040126000030 |
| Provider Name | Robert J Dittoe |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1184671174 PECOS PAC ID: 6305844051 Enrollment ID: I20061114000021 |
| Provider Name | Kelly A Ryen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588689780 PECOS PAC ID: 4486652138 Enrollment ID: I20061114000027 |
| Provider Name | Xuan T Pham |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1134421035 PECOS PAC ID: 5698900629 Enrollment ID: I20131029001970 |
| Provider Name | Monica R Braun |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467061432 PECOS PAC ID: 6103239769 Enrollment ID: I20201229001114 |
| Provider Name | Farah Hamade |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164045159 PECOS PAC ID: 3476966912 Enrollment ID: I20201230001856 |
| Provider Name | Kyle D Martin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1760004071 PECOS PAC ID: 9335563253 Enrollment ID: I20210729003128 |
| Provider Name | Bradley F Ortisi |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114619426 PECOS PAC ID: 8729432638 Enrollment ID: I20230926004400 |
| Mailing Address | Practice Location Address |
|---|---|
| Trillium Vision Care Of New Lexington, Llc Po Box 540, New Lexington, OH 43764-0540 Ph: (740) 342-1784 | Trillium Vision Care Of New Lexington, Llc 391 Lincoln Park Dr, New Lexington, OH 43764-1080 Ph: (740) 342-1784 |
James Gerald Shover, O.D Optometrist Medicare: Not Enrolled in Medicare Practice Location: 123 Mill St, New Lexington, OH 43764 Phone: 740-743-2243 | |
John Manard, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 391 Lincoln Park Dr, New Lexington, OH 43764 Phone: 740-342-1784 | |
Dr. Robert J Dittoe, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 391 Lincoln Park Dr, New Lexington, OH 43764 Phone: 740-342-1784 Fax: 740-342-1791 | |
Monica Braun, OD Optometrist Medicare: Medicare Enrolled Practice Location: 391 Lincoln Park Dr, New Lexington, OH 43764 Phone: 740-342-1784 | |
Robert J. Dittoe, O.d., Inc. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 391 Lincoln Park Dr, New Lexington, OH 43764 Phone: 740-342-1784 Fax: 740-342-1791 | |
Dr. Kyle D Martin, OD Optometrist Medicare: May Accept Medicare Assignments Practice Location: 391 Lincoln Park Dr, New Lexington, OH 43764 Phone: 740-342-1784 Fax: 740-342-1791 |