Matthew Gifford, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

18003913A Issued in IN

Practice address

5111 N Main St Reet
Ste 200
Mishawaka, IN 46545

Phone

(574) 277-8121

NPI assigned

Jul 1, 2015

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 1

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Indiana LLCGroup PAC ID 5496091316, 82 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Lebanon, IN
  • NPI 1083100424
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Mishawaka, IN
  • NPI 1336635770
  NPD
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Munster, IN
  • NPI 1922974526
  NPD
• Indiana University

  • Optometrist
  • Indianapolis, IN
  • NPI 1497799787
  NPD (past)

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1124401773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 N MAIN ST REET",
            "address_2": "STE 200",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "46545",
            "telephone_number": "574-277-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIFFORD",
        "first_name": "MATTHEW",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-01",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003913A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201299850",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Johnny Lee Gerardot Jr., MD
• Adam Gregory Gerhardt
• Laura Satka Gettler, FNP
• Caitlin Giddens, FNP-BC
• Daniel Ray Gifford
• John S Gilbert, D.O.
• Christopher Michael Gildea, PHARMD
• Charlene Giles
• Colette Gillis
• Eric A Gingerich

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

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