Active NPI
Tara Lynn Svatos, O.D.
- Optometrist
- Granger, IN
National Provider Identifier
1336146497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 18002580
- Practice address
- 13197 State Road 23
Granger, IN 46530 - Phone
- (574) 247-1500
- Fax
- (574) 247-1505
- NPI assigned
- Jul 5, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18002580 | IN | Primary |
Addresses
Primary practice location
13197 State Road 23
Granger, IN 46530
Mailing address
PO Box 549
Wabash, IN 46992-0549
Phone (260) 569-9550
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 410049816 | Other | IN | MEDICARE RAILROAD |
| 000000277906 | Other | IN | ANTHEM BCBS |
| P01598940 | Other | IN | RAILROAD MEDICARE |
| 4777440001 | Other | IN | DME MAC |
| 100093180 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18002580 | IN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kevin R Hickman | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Optometrist
- Bremen, IN
- NPI 1407903966
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534291200000",
"number": "1336146497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 549",
"city": "WABASH",
"state": "IN",
"postal_code": "469920549",
"telephone_number": "260-569-9550",
"fax_number": "260-569-0760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13197 STATE ROAD 23",
"city": "GRANGER",
"state": "IN",
"postal_code": "46530",
"telephone_number": "574-247-1500",
"fax_number": "574-247-1505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SVATOS",
"first_name": "TARA",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-05",
"last_updated": "2018-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "18002580",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "410049816",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000277906",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01598940",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DME MAC",
"identifier": "4777440001",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100093180",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Granger, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.