Richard Scott Carlson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046009441 Issued in IL

Practice address

851 Eastport Centre Dr
Valparaiso, IN 46383-2909

Phone

(219) 464-8223

Fax

(219) 531-2356

NPI assigned

Aug 11, 2005

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 6

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

Specialty

Optometry

Education

Indiana University - School of Optometry, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Indiana Eye and Laser Center PCGroup PAC ID 5193701340, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drcarlson@nwieyeandlasercenter.eyefinity-direct.com

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.

• Northwest Indiana Eye & Laser Center PC

  • Ophthalmology Physician
  • Valparaiso, IN
  • NPI 1336212117

  Optometrist

  Medicare reassignment Care Compare group NPD
• Vision Surgery and Laser Center of Indiana LLC

  • Ambulatory Surgical Clinic/Center
  • Valparaiso, IN
  • NPI 1336806967
  NPD

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1073515938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 MARQUETTE ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832509",
            "telephone_number": "219-464-8223",
            "fax_number": "219-531-2356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 EASTPORT CENTRE DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832909",
            "telephone_number": "219-464-8223",
            "fax_number": "219-531-2356"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1003 S Edgewood Dr",
            "address_purpose": "LOCATION",
            "city": "Knox",
            "state": "IN",
            "postal_code": "465348226",
            "country_code": "US",
            "telephone_number": "574-772-2012",
            "fax_number": "574-772-2221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "RICHARD",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01635025",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDIARE RAILROAD",
            "identifier": "P00082449",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC.BS",
            "identifier": "000000549868",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036059451",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2151005",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200883420",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Payton Cantu
• Sandra Carbajal, LMHC, LCAC
• Care Counseling Services
• Carebridge Independent Living LLC
• Carl Hufford LCSW
• Ruth Carlson
• Sandra R Carlson, LCSW, LMFT
• Stephanie Lynn Carmean, MD
• Amie Marie Carns, DPT
• Katie-Sue Carothers

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.