NPIMap

Organization Active NPI

City Optical Co., Inc.

  • Optometrist
  • Muncie, IN
National Provider Identifier
1306070768
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
CITY OPTICAL CO., INC.
Practice address
1511 W McGalliard Rd
Muncie, IN 47304-2204
Phone
(765) 289-8005
Fax
(317) 924-3741
NPI assigned
May 13, 2009
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Larry S Tavel, MD
Title
President
Phone
(317) 924-1300

Other NPIs on the same Medicare enrollment 29

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 29

Corporate family (same tax ID) 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 44

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040128000867 IN Part B Supplier - Clinic/Group Practice 5597668574 Receives reassigned benefits from 58 practitioners
29 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Indianapolis, IN; Kokomo, IN; Lebanon, IN; Martinsville, IN; Merrillville, IN; Mooresville, IN; Muncie, IN; New Castle, IN…

National Provider Directory

National Provider Directory
Tax ID family
City Optical Company (26 organizations share this tax ID)

Locations

12676 E 116th St
Fishers, IN 46037
Phone (317) 785-5034

2940 E 38th St
Ste 102
Indianapolis, IN 46218

2438 N Lebanon St
Ste 300
Lebanon, IN 46052
Phone (765) 484-6540

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 18001649 IN
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1511 W McGalliard Rd
Muncie, IN 47304-2204

Mailing address

2839 Lafayette Rd
Indianapolis, IN 46222-2147
Phone (317) 924-1300

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
200946620AMedicaidIN

Other names 1

NPPES NPI Registry
  • Dr Tavel Family Eye Care Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 27, 2021.

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635292800000",
    "number": "1306070768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2839 LAFAYETTE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462222147",
            "telephone_number": "317-924-1300",
            "fax_number": "317-924-3741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 W MCGALLIARD RD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473042204",
            "telephone_number": "765-289-8005",
            "fax_number": "317-924-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OPTICAL CO., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-13",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A",
        "authorized_official_last_name": "TAVEL",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-924-1300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001649",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200946620A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr Tavel Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dr Tavel Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.