Organization Active NPI

Levin Eye Care Center, P.C.

  • Vision Therapy Optometrist
  • Whiting, IN
National Provider Identifier
1114101334
Registry record updated Jan 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
License
18001641 Issued in IN
Legal business name
LEVIN EYE CARE CENTER, P.C.
Practice address
1334 119TH St.
Whiting, IN 46394
Phone
(219) 659-3050
Fax
(219) 659-3053
NPI assigned
Dec 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2008

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

Authorized official

Name
Miss Angelica Carrillo
Title
Office Manager
Phone
(219) 659-3050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vision Therapy OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152WV0400X 18001641 IN Primary

Addresses

Primary practice location

1334 119TH St.
Whiting, IN 46394

Mailing address

1334 119TH St
Whiting, IN 46394-1631
Phone (219) 659-3050

Other identifiers 1

IdentifierTypeStateIssuer
1336220458OtherINNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090313000437 IN Part B Supplier - Clinic/Group Practice 3678630860 Receives reassigned benefits from 1 practitioner
Practice locations: Whiting, IN
O20100930088513 IN DME Supplier - Physician - Optometrist 3678630860 Practice locations: Whiting, IN

National Provider Directory

National Provider Directory

Locations

1334 119th St
Whiting, IN 46394
Phone (219) 659-3050

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201132800000",
    "number": "1114101334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1334 119TH ST",
            "city": "WHITING",
            "state": "IN",
            "postal_code": "463941631",
            "telephone_number": "219-659-3050",
            "fax_number": "219-659-3053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1334 119TH ST.",
            "city": "WHITING",
            "state": "IN",
            "postal_code": "46394",
            "telephone_number": "219-659-3050",
            "fax_number": "219-659-3053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEVIN EYE CARE CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-24",
        "last_updated": "2008-01-24",
        "status": "A",
        "authorized_official_last_name": "CARRILLO",
        "authorized_official_first_name": "ANGELICA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "219-659-3050",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "IN",
            "license": "18001641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1336220458",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiting, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.