NPIMap

Organization Active NPI

Northwest Indiana Eye Associates, PC

  • Ophthalmology Physician
  • Valparaiso, IN
National Provider Identifier
1336115237
Registry record updated Feb 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
NORTHWEST INDIANA EYE ASSOCIATES, PC
Practice address
2101 Burlington Beach Rd
Valparaiso, IN 46383-1665
Phone
(219) 462-0309
Fax
(219) 464-4291
NPI assigned
Feb 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2015

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

Authorized official

Name
Dr. Myron I. Lewyckyj, M.D.NPI 1831165760
Title
President
Phone
(219) 462-0309

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

2101 Burlington Beach Rd
Valparaiso, IN 46383-1665

Mailing address

2101 Burlington Beach Rd
Valparaiso, IN 46383-1665
Phone (219) 462-0309

Other identifiers 1

IdentifierTypeStateIssuer
100315020MedicaidIN

Other names 1

  • d/b/a Lewyckyj-Taglia- Felton Eye Clinics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040924000081 IN Part B Supplier - Clinic/Group Practice 1355319583 Receives reassigned benefits from 7 practitioners
2 other NPIs on this enrollment
Practice locations: Crown Point, IN; Munster, IN; Valparaiso, IN
O20060717000057 IN Part B Supplier - Clinic/Group Practice 1355319583 Receives reassigned benefits from 6 practitioners
2 other NPIs on this enrollment
Practice locations: Crown Point, IN; Munster, IN; Valparaiso, IN
O20100930013866 IN DME Supplier - Physician - OphthalmologyDME Supplier - OpticianDME Supplier - Physician - Optometrist 1355319583 Practice locations: Valparaiso, IN

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

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

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
Family Focus Optical2101 Burlington Beach Rd, Valparaiso, IN 46383-1665(219) 462-0311 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Aug 7, 1991

National Provider Directory

National Provider Directory
Tax ID family
Felton Evans Eye Clinic3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424044800000",
    "number": "1336115237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 BURLINGTON BEACH RD",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463831665",
            "telephone_number": "219-462-0309",
            "fax_number": "219-464-4291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 BURLINGTON BEACH RD",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463831665",
            "telephone_number": "219-462-0309",
            "fax_number": "219-464-4291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST INDIANA EYE ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-28",
        "last_updated": "2015-02-16",
        "status": "A",
        "authorized_official_last_name": "LEWYCKYJ",
        "authorized_official_first_name": "MYRON",
        "authorized_official_middle_name": "I.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-462-0309",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100315020",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "d/b/a Lewyckyj-Taglia- Felton Eye Clinics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2015; 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.