Todd J Fettig, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

18002362A Issued in IN

Practice address

711 N River Dr
Marion, IN 46952-2646

Phone

(765) 664-9637

NPI assigned

Jun 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Indiana University - School of Optometry, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Indiana Professional PCGroup PAC ID 2365826179, 30 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aeg Indiana Professional PC

  • Optometrist
  • Warsaw, IN
  • NPI 1043944127
  Medicare reassignment Care Compare group NPD
• Dr Tabitha G Temple PC

  • Optometrist
  • Warsaw, IN
  • NPI 1851484125
  NPD (past)
• Eye Associates Group, LLC

  • Optometrist
  • Hartford City, IN
  • NPI 1649324831
  NPD (past)

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296518400000",
    "number": "1326074931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 N RIVER DR",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522646",
            "telephone_number": "765-664-9637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 N RIVER DR",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522646",
            "telephone_number": "765-664-9637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETTIG",
        "first_name": "TODD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2011-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002362A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100059630",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karan Jean Faust, RN
• Emberly Fellhoelter
• Sarah Jane Felver, PTA
• Robyn Ferguson
• Aubrey Ferren, RBT
• Daniel T Fidler
• Betty L Field, P.T.A.
• Dane Fife
• James Allen Fischer, MSN,RN-BC
• Jennifer Ruth Fisher, M.ED. CRC

• Optometrist in Marion, IN
• Providers in Marion, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.