Haylee Bourlier, OD
Individual provider Active NPI Optometrist · Fort Wayne, IN
NPI 1245948181 · NPPES record last updated Nov 9, 2022
Key facts
- NPI
- 1245948181
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 18004368B (IN)
- Practice address
- 2121 Lake Ave
Fort Wayne, IN 46805-5100 - Phone
- (260) 426-5431
- NPI assigned
- Nov 9, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Manchester Eyecare LLC
Practice addresses (Care Compare)
901 State Rd 114
North Manchester, IN 46962-1967
Phone (260) 306-3937
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230801000878 | IN | Practitioner - Optometry | 9133580657 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18004368B | IN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Manchester Eyecare LLC | Optometrist | Current |
Accepting new patients |
Locations
901 State Road 114 W
North Manchester, IN 46962
Phone (260) 306-3937
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18004368B | IN | Yes |
Addresses
Primary practice location
2121 Lake Ave
Fort Wayne, IN 46805-5100
Mailing address
2719 Ascension CT
Fort Wayne, IN 46818-8537
Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 9, 2022. 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.
- Order and Referring (CMS).
- 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.