Individual provider Active NPI

Gary Ludwig, O.D.

  • Ophthalmology Physician
  • Saint Joseph, MI
National Provider Identifier
1174651632
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4901002918 Issued in MI
Practice address
1101 Main St
Saint Joseph, MI 49085-1509
Phone
(269) 983-3461
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 4901002918 MI Primary

Addresses

Primary practice location

1101 Main St
Saint Joseph, MI 49085-1509

Mailing address

1101 Main St
Saint Joseph, MI 49085-1509
Phone (269) 983-3461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20110801000034 MI Practitioner - Optometry 5799953162 Practice locations: Saint Joseph, MI

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1101 Main St
Saint Joseph, MI 49085-1509
Phone (269) 983-3461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174651632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MAIN ST",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851509",
            "telephone_number": "269-983-3461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MAIN ST",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851509",
            "telephone_number": "269-983-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDWIG",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4901002918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.