Individual provider Active NPI

Eric G Friedman, M.D.

  • Ophthalmology Physician
  • Valparaiso, IN
National Provider Identifier
1164620530
Registry record updated Aug 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
01028202 Issued in IN
Practice address
552 W Lincolnway
Valparaiso, IN 46385-5531
Phone
(219) 464-3937
Fax
(219) 462-1534
NPI assigned
Jul 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 01028202 IN Primary

Addresses

Primary practice location

552 W Lincolnway
Valparaiso, IN 46385-5531

Mailing address

552 W Lincolnway
Valparaiso, IN 46385-5531
Phone (219) 464-3937

Other identifiers 2

IdentifierTypeStateIssuer
100208400AMedicaidIN
000000102346OtherANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250035200000",
    "number": "1164620530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "552 W LINCOLNWAY",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463855531",
            "telephone_number": "219-464-3937",
            "fax_number": "219-462-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "552 W LINCOLNWAY",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463855531",
            "telephone_number": "219-464-3937",
            "fax_number": "219-462-1534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "ERIC",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-06",
        "last_updated": "2009-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "01028202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100208400A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000102346",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.