Individual provider Active NPI

Ann U Madden, OD

  • Optometrist
  • Warsaw, IN
National Provider Identifier
1285660902
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003072A Issued in IN
Practice address
2251 Dubois Dr
Warsaw, IN 46580-3212
Phone
(574) 269-2777
Fax
(574) 371-4697
NPI assigned
Jun 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18003072A IN Primary

Addresses

Primary practice location

2251 Dubois Dr
Warsaw, IN 46580-3212

Mailing address

2251 Dubois Dr
Warsaw, IN 46580-3212
Phone (574) 269-2777

Other identifiers 2

IdentifierTypeStateIssuer
201027750MedicaidIN
P00442910OtherRAILROAD MEDICARE

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
I20040924000590 IN Practitioner - Optometry 8123096567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grossnickle Eye Center IncGroup PAC ID 7810897758, 12 clinicians

Practice addresses (Care Compare)

2251 Dubois Dr
Warsaw, IN 46580-3212
Phone (574) 269-2777

Merit-based Incentive Payment System (MIPS)

Final score
89.94 of 100Reported as group
Quality
91.45
Improvement activities
40
Cost
77.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18003072AINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Grossnickle Eye Center, Inc. CurrentSince May 1, 2011 Accepting new patients
Grossnickle Eye Center, Inc. CurrentSince May 1, 2011 Accepting new patients
Grossnickle Eye Center, Inc. Current Accepting new patients

Locations

1510 Osolo Rd
Elkhart, IN 46514
Phone (574) 266-6100

4330 Edison Lakes Pkwy
Ste A
Mishawaka, IN 46545
Phone (574) 269-2777

2855 Miller Dr
Ste 121
Plymouth, IN 46563
Phone (574) 647-1600

2251 Dubois Dr
Warsaw, IN 46580
Phone (574) 269-2777

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/mi-gecenter

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1285660902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2251 DUBOIS DR",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803212",
            "telephone_number": "574-269-2777",
            "fax_number": "574-371-4697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2251 DUBOIS DR",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803212",
            "telephone_number": "574-269-2777",
            "fax_number": "574-371-4697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDEN",
        "first_name": "ANN",
        "middle_name": "U",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003072A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201027750",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00442910",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, IN

Sources for this page

Verify at the official NPI Registry.