Individual provider Active NPI

Mark Labhart, OD

  • Optometrist
  • Tell City, IN
National Provider Identifier
1114082039
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1800318 Issued in IN
Practice address
8570 Highway 37
Tell City, IN 47586-1705
Phone
(812) 547-3396
Fax
(812) 547-5272
NPI assigned
Dec 22, 2006
Last updated
Jun 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1549DT KY
Optometrist 152W00000X 1800318 IN Primary

Addresses

Primary practice location

8570 Highway 37
Tell City, IN 47586-1705

Mailing address

PO Box 457
Tell City, IN 47586-0457
Phone (812) 547-3396

Other identifiers 1

IdentifierTypeStateIssuer
200453070AMedicaidIN

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
I20111213000496 IN Practitioner - Optometry 5496835399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eric Burris and Joseph Leclere Et Al Burris Leclere LLCGroup PAC ID 9032230305, 3 clinicians

Practice addresses (Care Compare)

715 Main St
Tell City, IN 47586-1705
Phone (812) 547-3396

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1800318INMDOptometrist
1549DTKYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eric Burris & Joseph Leclere Et Al Burris Leclere LLC Optometrist CurrentSince Oct 23, 2011 Accepting new patients

Locations

715 Main St
Tell City, IN 47586
Phone (812) 482-6424

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

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1114082039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 457",
            "city": "TELL CITY",
            "state": "IN",
            "postal_code": "475860457",
            "telephone_number": "812-547-3396",
            "fax_number": "812-547-5272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8570 HIGHWAY 37",
            "city": "TELL CITY",
            "state": "IN",
            "postal_code": "475861705",
            "telephone_number": "812-547-3396",
            "fax_number": "812-547-5272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABHART",
        "first_name": "MARK",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1549DT",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "1800318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200453070A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tell City, IN

Sources for this page

Verify at the official NPI Registry.