Individual provider Active NPI

John David Miles, OPTOMETRIST

  • Optometrist
  • Evansville, IN
National Provider Identifier
1164483202
Registry record updated May 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002272 Issued in IN
Practice address
415 Metro Ave
Evansville, IN 47715-2805
Phone
(812) 476-2000
Fax
(812) 477-1533
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002272 IN Primary

Addresses

Primary practice location

415 Metro Ave
Evansville, IN 47715-2805

Mailing address

415 Metro Ave
Evansville, IN 47715-2805
Phone (812) 476-2000

Other identifiers 1

IdentifierTypeStateIssuer
M400031448OtherININDIVIDUAL PTAN

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
I20101227000354 IN Practitioner - Optometry 0941315089 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

415 Metro Ave
Evansville, IN 47715-2805
Phone (812) 476-2000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002272INMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Miles Eye Care, PC Optometrist CurrentSince Nov 1, 2010 Accepting new patients
Ohio Valley Eye Institute P C Optometrist CurrentSince Nov 1, 2021 Accepting new patients
Vision Service Corporation Optometrist Past Accepting new patients
Specialty Eyecare of Evansville, LLC Optometrist PastSince Feb 2, 2013 Accepting new patients

Locations

415 Metro Ave
Evansville, IN 47715
Phone (812) 476-2000

954 S Kenmore Dr
Evansville, IN 47714
Phone (812) 402-2020

1001 Walnut St
Evansville, IN 47713
Phone (812) 421-2020

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432166400000",
    "number": "1164483202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 METRO AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152805",
            "telephone_number": "812-476-2000",
            "fax_number": "812-477-1533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 METRO AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152805",
            "telephone_number": "812-476-2000",
            "fax_number": "812-477-1533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "OPTOMETRIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2015-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PTAN",
            "identifier": "M400031448",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.