Susan Gailmard, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18001956AB Issued in IN

Practice address

630 Ridge Rd
Munster, IN 46321-1610

Phone

(219) 836-1738

Fax

(219) 836-2822

NPI assigned

Feb 13, 2007

Sex

Female

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 1

Other names 1

• Susan Longa Former name

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Gailmard Eye Center LLC

  • Optometrist
  • Munster, IN
  • NPI 1982746293
  Medicare reassignment NPD

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238976000000",
    "number": "1104968585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 RIDGE RD",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211610",
            "telephone_number": "219-836-1738",
            "fax_number": "219-836-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 RIDGE RD",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211610",
            "telephone_number": "219-836-1738",
            "fax_number": "219-836-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAILMARD",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2009-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001956AB",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME MAC",
            "identifier": "0407090001",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "LONGA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary D Fugett, DO
• Brett Fulka II
• Alexis Funk
• Gailmard Eye Center LLC
• Neil Bennett Gailmard, O.D.
• Rebecca E Galante, MD
• Galen Inpatient Physicians PC
• Amanda Louise Galik, DNP, CRNA
• Jenna Lynn Galvan, DPT
• Gama PC Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.