Organization Active NPI

Southern Indiana Eye Associates LLC

  • Ophthalmology Physician
  • Jasper, IN
National Provider Identifier
1316970346
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
01050488A Issued in IN
Legal business name
SOUTHERN INDIANA EYE ASSOCIATES LLC
Practice address
200 Saint Charles St
Jasper, IN 47546-9053
Phone
(812) 482-6424
Fax
(812) 634-9701
NPI assigned
Jul 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Authorized official

Name
Dr. Judith Ann EnglertNPI 1770583635
Title
Physician
Phone
(812) 482-6424

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 01050488A IN Primary

Addresses

Primary practice location

200 Saint Charles St
Jasper, IN 47546-9053

Mailing address

200 Saint Charles St
Jasper, IN 47546-9053
Phone (812) 482-6424

Other identifiers 1

IdentifierTypeStateIssuer
200479960AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040211000941 IN Part B Supplier - Clinic/Group Practice 3870487796 Receives reassigned benefits from 1 practitioner
Practice locations: Evansville, IN; Jasper, IN
O20100930071076 IN DME Supplier - Physician - OphthalmologyDME Supplier - Optician 3870487796 Practice locations: Jasper, IN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Southern Indiana Eye Associates,LLC200 Saint Charles St, Jasper, IN 47546-9053(812) 482-6424 Ocular Prostheses|Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 2004

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1316970346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SAINT CHARLES ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475469053",
            "telephone_number": "812-482-6424",
            "fax_number": "812-634-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SAINT CHARLES ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475469053",
            "telephone_number": "812-482-6424",
            "fax_number": "812-634-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN INDIANA EYE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A",
        "authorized_official_last_name": "ENGLERT",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "812-482-6424",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "01050488A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200479960A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.