Active NPI
Alan Richard Crebo, M.D.
- Ophthalmology Physician
- Kokomo, IN
National Provider Identifier
1013914845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 01027403
- Practice address
- 1601 W Lincoln Rd
Kokomo, IN 46902-3275 - Phone
- (765) 453-5696
- Fax
- (765) 455-4323
- NPI assigned
- Jul 7, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 01027403 | IN | Primary |
Addresses
Primary practice location
1601 W Lincoln Rd
Kokomo, IN 46902-3275
Mailing address
PO Box 6550
Kokomo, IN 46904-6550
Phone (765) 453-5696
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100188240 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Eye Consultants, P.C. | Past | Accepting new patients | |
| Central Indiana Eye Institute PC | Ophthalmology | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- Greensburg, IN
- NPI 1013480482
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355356800000",
"number": "1013914845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6550",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469046550",
"telephone_number": "765-453-5696",
"fax_number": "765-455-4323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 W LINCOLN RD",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469023275",
"telephone_number": "765-453-5696",
"fax_number": "765-455-4323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CREBO",
"first_name": "ALAN",
"middle_name": "RICHARD",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-07",
"last_updated": "2012-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IN",
"license": "01027403",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100188240",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kokomo, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.