Individual provider Active NPI

Nathan D Trump, O.D.

  • Optometrist
  • North Manchester, IN
National Provider Identifier
1245290923
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003366 Issued in IN
Practice address
1201 State Road 114 E
North Manchester, IN 46962
Phone
(260) 982-8681
Fax
(260) 982-2912
NPI assigned
Mar 25, 2006
Last updated
Aug 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18003366 IN Primary

Addresses

Primary practice location

1201 State Road 114 E
North Manchester, IN 46962

Mailing address

1201 State Road 114 E
North Manchester, IN 46962-9393
Phone (260) 982-8681

Other identifiers 1

IdentifierTypeStateIssuer
200522090MedicaidIN

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
I20050721000306 IN Practitioner - Optometry 5698702694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Eye Consultants PCGroup PAC ID 2961399217, 71 clinicians

Practice addresses (Care Compare)

1240 Medical Park Dr
Fort Wayne, IN 46825-5888
Phone (260) 471-2375

Merit-based Incentive Payment System (MIPS)

Final score
55.99 of 100Reported as group
Quality
31.67
Improvement activities
40
Cost
78.58

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18003366INMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Eye Consultants, P.C. Current Accepting new patients
Midwest Eye Consultants, P.C. Optometrist CurrentSince Jul 8, 2005 Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients
Midwest Eye Consultants P.C. Optometrist Past Accepting new patients
Midwest Eye Consultants, P.C. Optometrist PastSince Jul 8, 2005 Accepting new patients
Midwest Eye Consultants Ohio, Inc Optometrist PastSince Nov 4, 2016 Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients

Locations

1240 Medical Park Dr
Fort Wayne, IN 46825
Phone (260) 471-2375

1240 Medical Park Dr
#17
Fort Wayne, IN 46825
Phone (260) 471-2375

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1245290923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 STATE ROAD 114 E",
            "city": "NORTH MANCHESTER",
            "state": "IN",
            "postal_code": "469629393",
            "telephone_number": "260-982-8681",
            "fax_number": "260-982-2912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 STATE ROAD 114 E",
            "city": "NORTH MANCHESTER",
            "state": "IN",
            "postal_code": "46962",
            "telephone_number": "260-982-8681",
            "fax_number": "260-982-2912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUMP",
        "first_name": "NATHAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-25",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200522090",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Manchester, IN

Sources for this page

Verify at the official NPI Registry.