Masoud Ghohestani, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18003027A Issued in IN

Practice address

100 Sycamore Estates Dr
Aurora, IN 47001-1488

Phone

(812) 926-4836

Fax

(812) 926-4651

NPI assigned

May 20, 2006

Last updated

Jan 24, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN, OH2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Ohio State University - College of Optometry, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Vision Care Center, LLC

  dba Masoud Ghohestani OD

  • Clinic/Center
  • Aurora, IN
  • NPI 1609829480

  OH

  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1013961457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4174",
            "city": "LAWRENCEBURG",
            "state": "IN",
            "postal_code": "470254174",
            "telephone_number": "812-926-4836",
            "fax_number": "812-926-4651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SYCAMORE ESTATES DR",
            "city": "AURORA",
            "state": "IN",
            "postal_code": "470011488",
            "telephone_number": "812-926-4836",
            "fax_number": "812-926-4651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 E Main St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "IN",
            "postal_code": "473745934",
            "country_code": "US",
            "telephone_number": "765-965-6827",
            "fax_number": "765-965-2710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHOHESTANI",
        "first_name": "MASOUD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003027A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2278664",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201392310",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Lauren Fox, APRN
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• Roberta Hall
• Luciana Hartke, APRN
• Jon Philip Hautzenroeder, CNP

• Optometrist in Aurora, IN
• Providers in Aurora, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.