Individual provider Active NPI

Michael R Hodges, M.D.

  • Ophthalmology Physician
  • Evansville, IN
National Provider Identifier
1104823566
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
01055572A Issued in IN
Practice address
1020 W Buena Vista Rd
Evansville, IN 47710-5150
Phone
(812) 423-3131
Fax
(812) 426-7020
NPI assigned
Jun 30, 2005
Last updated
Dec 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 01055572A IN Primary

Addresses

Primary practice location

1020 W Buena Vista Rd
Evansville, IN 47710-5150

Mailing address

1020 W Buena Vista Rd
Evansville, IN 47710-5150
Phone (812) 423-3131

Other identifiers 1

IdentifierTypeStateIssuer
200357080AMedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Direct@TheEyeGrpOfSoIndianaLLCEvansvilleIN.CompulinkDirect.com Other

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091210000216 IN Practitioner - Ophthalmology 6800861006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Texas Tech University Health Science Center School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1020 W Buena Vista Rd
Evansville, IN 47710-5150
Phone (812) 423-3131

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.86 of 100Reported as group
Quality
97.37
Improvement activities
40
Cost
79.69

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Eye Group of Southern Indiana LLC Ophthalmology CurrentSince Jul 8, 2002 Accepting new patients
The Eye Group of Southern Indiana, LLC Ophthalmology CurrentSince Jul 8, 2002 Accepting new patients

Locations

1020 W Buena Vista Rd
Evansville, IN 47710
Phone (812) 422-6977

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1104823566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 W BUENA VISTA RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477105150",
            "telephone_number": "812-423-3131",
            "fax_number": "812-426-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 W BUENA VISTA RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477105150",
            "telephone_number": "812-423-3131",
            "fax_number": "812-426-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGES",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "01055572A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200357080A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Direct@TheEyeGrpOfSoIndianaLLCEvansvilleIN.CompulinkDirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Email Address",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1020 W Buena Vista Rd",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477105150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.