Valerie Renee Anderson, O.D.
Individual provider Active NPI Optometrist · Saint John, IN
NPI 1154489177 · NPPES record last updated Dec 31, 2013
Key facts
- NPI
- 1154489177
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 18003351 (IN)
- Practice address
- 9270 Wicker Ave
Suite a
Saint John, IN 46373-8508 - Phone
- (219) 365-1227
- Fax
- (219) 365-1552
- NPI assigned
- Dec 4, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aeg Indiana Professional PC
Practice addresses (Care Compare)
9270 Wicker Ave
Clearvue Eyecare
Saint John, IN 46373-8508
Phone (219) 365-1227
9270 Wicker Ave
Suite a
Saint John, IN 46373-8509
Phone (219) 365-1227
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050713000233 | IN | Practitioner - Optometry | 0446286223 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18003351 | IN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aeg Indiana Professional PC | Optometrist | Current |
Accepting new patients |
| Anderson Eye Care Inc | Optometrist | Current | Accepting new patients |
| Anderson Eye Care PC | Optometrist | Current |
Accepting new patients |
| A&K Kouklakis OD. P.C. | Optometrist | Past | Accepting new patients |
Locations
9270 Wicker Ave
Saint John, IN 46373
Phone (219) 627-3133
9270 Wicker Ave
Ste A
Saint John, IN 46373
Phone (219) 365-1227
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18003351 | IN | Yes |
Addresses
Primary practice location
9270 Wicker Ave
Suite a
Saint John, IN 46373-8508
Mailing address
930 Chippewa Dr
Crown Point, IN 46307-4502
Phone (219) 310-8912
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200521640 | Medicaid | IN |
Other providers in Saint John, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 31, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.