Nathanael David Oglesbee, O.D.
Individual provider Active NPI Optometrist · Nappanee, IN
NPI 1316945520 · NPPES record last updated Oct 21, 2014
Key facts
- NPI
- 1316945520
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 18001832B (IN)
- Practice address
- 207 E Market St
Nappanee, IN 46550-2119 - Phone
- (574) 773-4732
- Fax
- (574) 773-2164
- NPI assigned
- Jul 12, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|---|
| I20100621000344 | IN | Practitioner - Optometry | 3072643964 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18001832B | IN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nappanee Family Eyecare, P.C. | Optometrist | Current |
Accepting new patients |
Locations
1752 E Market St
Nappanee, IN 46550
Phone (574) 773-4341
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18001832B | IN | Yes |
Addresses
Primary practice location
207 E Market St
Nappanee, IN 46550-2119
Mailing address
207 E Market St
Nappanee, IN 46550-2119
Phone (574) 773-4732
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 410004217 | Other | IN | RAILROAD MEDICARE |
| 0198900001 | Other | IN | DMERC |
| 100113090A | Medicaid | IN |
Other providers in Nappanee, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2014. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.