Individual provider Active NPI

Brian Andrew Faust, O.D.

  • Optometrist
  • South Bend, IN
National Provider Identifier
1144486168
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003536A Issued in IN
Practice address
220 N Ironwood Dr
South Bend, IN 46615
Phone
(574) 289-3937
Fax
(574) 280-7355
NPI assigned
Jul 29, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18003536A IN Primary

Addresses

Primary practice location

220 N Ironwood Dr
South Bend, IN 46615

Mailing address

PO Box 549
835 N. Cass St.
Wabash, IN 46992-0549
Phone (260) 569-9550

Other identifiers 1

IdentifierTypeStateIssuer
201014610MedicaidIN

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
I20110420000705 IN Practitioner - Optometry 9739364548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Eye Consultants PCGroup PAC ID 2961399217, 71 clinicians

Practice addresses (Care Compare)

328 S Main St
Mishawaka, IN 46544-2115
Phone (574) 256-5606

Merit-based Incentive Payment System (MIPS)

Final score
55.99 of 100Reported as group
Quality
31.67
Improvement activities
40
Cost
78.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18003536AINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Eye Consultants, PC Optometrist CurrentSince Jul 1, 2012 Accepting new patients
Midwest Eye Consultants, P.C. Current Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients

Locations

301 J St
Laporte, IN 46350
Phone (219) 326-9569

328 S Main St
Mishawaka, IN 46544
Phone (219) 256-5606

220 N Ironwood Dr
#42
South Bend, IN 46615
Phone (574) 289-3937

220 N Ironwood Dr
South Bend, IN 46615
Phone (574) 233-2626

17615 State Road 23
South Bend, IN 46635
Phone (574) 234-7600

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1144486168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "address_2": "835 N. CASS ST.",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469920549",
            "telephone_number": "260-569-9550",
            "fax_number": "260-569-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N IRONWOOD DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "46615",
            "telephone_number": "574-289-3937",
            "fax_number": "574-280-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUST",
        "first_name": "BRIAN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-29",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003536A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201014610",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.