Provider Demographics
NPI:1164526604
Name:SCHOECK, SARA ELISABETH (OD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:ELISABETH
Last Name:SCHOECK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVENUE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106
Practice Address - Country:US
Practice Address - Phone:216-844-3601
Practice Address - Fax:440-899-4455
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4386T292152W00000X
OH4386152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000524086OtherANTHEM
OH000000358133OtherANTHEM BCBS
OH0887018OtherBCMH
OHP00641582OtherRAILROAD MEDICARE
OH0887018Medicaid
OH414696OtherWELLCARE
OH4470926OtherAETNA
OH751005OtherBUCKEYE
OH10938076500OtherBWC
OH10938076500OtherBWC
OH0724835Medicare ID - Type Unspecified
OHSC0724836Medicare PIN
OHU34774Medicare UPIN