Zachary Edward Laskovich, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

18004220A Issued in IN

Practice address

3409 N Anthony Blvd
Fort Wayne, IN 46805-2233

Phone

(765) 617-1890

Fax

(260) 484-0616

NPI assigned

Jun 29, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Ohio State University - College of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Frey Vision Group of Indiana IncGroup PAC ID 3779868203, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Frey Vision Group of Indiana Inc

  • Optometrist
  • Fort Wayne, IN
  • NPI 1699109256
  Medicare reassignment Care Compare group NPD
• Neighborhood Health Clinics, Inc

  • Clinic/Center
  • Fort Wayne, IN
  • NPI 1548291222
  Medicare reassignment NPD
• Neighborhood Health Clinics, Inc

  • Clinic/Center
  • Fort Wayne, IN
  • NPI 1730989518
  NPD
• Longe Enterprises Corp

  • Eyewear Supplier
  • Fort Wayne, IN
  • NPI 1083294532
  NPD (past)

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1215554092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 N ANTHONY BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468052233",
            "telephone_number": "765-617-1890",
            "fax_number": "260-484-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 N ANTHONY BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468052233",
            "telephone_number": "765-617-1890",
            "fax_number": "260-484-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASKOVICH",
        "first_name": "ZACHARY",
        "middle_name": "EDWARD",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-29",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004220A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela P Lasalle, MD
• Christopher W Lasalle, MD
• Sarah Anne Lasalle, D.O.
• William B Lasalle, MD
• Brandee L Lash, PHARMD
• Paul E. Later, M.D.
• Jasmine Latham
• Makayla Latham
• Lily Luella Laturner
• Courtney J. Laubach, MD

• Optometrist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.