Apple Eyecare Syracuse LLC
Organization Active NPI Optometrist · Syracuse, IN
NPI 1245944982 · NPPES record last updated Jan 9, 2023
Key facts
- NPI
- 1245944982
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- APPLE EYECARE SYRACUSE LLC
- Practice address
- 612 S Huntington St
Syracuse, IN 46567-1804 - Phone
- (574) 457-4476
- NPI assigned
- Jan 9, 2023
- Organization subpart
- No
Authorized official
- Name
- Darren L Minnich, O.D.
- Title
- Owner
- Phone
- (574) 903-9333
Practitioners 4
-
Darren L Minnich, O.D.
-
Rod C Kaufman, O.D.
-
Megan Schlipf, OD
-
Jillian R Geiger, O.D.
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Apple Eyecare Syracuse LLC |
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230202000406 | IN | Part B Supplier - Clinic/Group Practice | 4385016203 |
Receives reassigned benefits from 4 practitioners Practice locations: Syracuse, IN |
| O20230410001963 | IN | DME Supplier - Physician - Optometrist | 4385016203 | Practice locations: Syracuse, IN |
National Provider Directory
Locations
612 S Huntington St
Syracuse, IN 46567
Phone (574) 457-4476
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
612 S Huntington St
Syracuse, IN 46567-1804
Mailing address
1752 E Market St
Nappanee, IN 46550-9216
Phone (574) 773-4341
NPI Registry JSON
{
"created_epoch": "1673222400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1673222400000",
"number": "1245944982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1752 E MARKET ST",
"city": "NAPPANEE",
"state": "IN",
"postal_code": "465509216",
"telephone_number": "574-773-4341",
"fax_number": "574-773-2324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "612 S HUNTINGTON ST",
"city": "SYRACUSE",
"state": "IN",
"postal_code": "465671804",
"telephone_number": "574-457-4476"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "APPLE EYECARE SYRACUSE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-01-09",
"last_updated": "2023-01-09",
"certification_date": "2023-01-08",
"status": "A",
"authorized_official_last_name": "MINNICH",
"authorized_official_first_name": "DARREN",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "574-903-9333",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.