Individual provider Active NPI

Pamela J Heyne-Thompson, O.D.

  • Optometrist
  • La Porte, IN
National Provider Identifier
1033178900
Registry record updated Dec 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002633 Issued in IN
Practice address
1231 N State Road 39
La Porte, IN 46350-2042
Phone
(219) 326-7681
Fax
(219) 326-7681
NPI assigned
Mar 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002633 IN Primary

Addresses

Primary practice location

1231 N State Road 39
La Porte, IN 46350-2042

Mailing address

1231 N State Road 39
La Porte, IN 46350-2042
Phone (219) 326-7681

Other identifiers 1

IdentifierTypeStateIssuer
247510AOtherINPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20060111000603 IN Practitioner - Optometry 2961425392 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002633INMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Garcia and Associates, PC Optometrist CurrentSince Jan 15, 2017 Accepting new patients

Locations

6501 Grape Rd
Ste 178
Mishawaka, IN 46545
Phone (574) 243-2384

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229472000000",
    "number": "1033178900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 N STATE ROAD 39",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463502042",
            "telephone_number": "219-326-7681",
            "fax_number": "219-326-7681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 N STATE ROAD 39",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463502042",
            "telephone_number": "219-326-7681",
            "fax_number": "219-326-7681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEYNE-THOMPSON",
        "first_name": "PAMELA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2008-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "247510A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Porte, IN

Sources for this page

Verify at the official NPI Registry.