Organization Active NPI

Crown Point Eye Care

  • Optometrist
  • Crown Point, IN
National Provider Identifier
1023535523
Registry record updated Aug 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
CROWN POINT EYE CARE
Practice address
10823 Broadway
Crown Point, IN 46307-7303
Phone
(219) 310-8032
NPI assigned
Aug 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2017

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

Authorized official

Name
Jovan Alavanja, ODNPI 1285070037
Title
Owner/Optometrist
Phone
(219) 789-9775

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

10823 Broadway
Crown Point, IN 46307-7303

Mailing address

446 Hillside Dr
Schererville, IN 46375-2390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180112000339 IN Part B Supplier - Clinic/Group Practice 4183983489 Receives reassigned benefits from 3 practitioners
Practice locations: Crown Point, IN

National Provider Directory

National Provider Directory

Locations

10823 Broadway
Crown Point, IN 46307
Phone (219) 310-8032

19 Dunster St
Cambridge, MA 02138
Phone (617) 312-0272

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503532800000",
    "number": "1023535523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 HILLSIDE DR",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "463752390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10823 BROADWAY",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077303",
            "telephone_number": "219-310-8032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWN POINT EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-24",
        "last_updated": "2017-08-24",
        "status": "A",
        "authorized_official_last_name": "ALAVANJA",
        "authorized_official_first_name": "JOVAN",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "219-789-9775",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.