Individual provider Active NPI

Olivia Rose Forthofer, OD

  • Optometrist
  • Greenwood, IN
National Provider Identifier
1356997993
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004189A Issued in IN
Practice address
980 Averitt Rd
Greenwood, IN 46143-9540
Phone
(317) 881-4143
NPI assigned
Aug 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18004189A IN Primary

Addresses

Primary practice location

980 Averitt Rd
Greenwood, IN 46143-9540

Mailing address

980 Averitt Rd
Greenwood, IN 46143-9540

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190830001124 IN Practitioner - Optometry 8628306503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Indiana LLCGroup PAC ID 5496091316, 82 clinicians

Practice addresses (Care Compare)

8411 Windfall LN
Suite 130
Camby, IN 46113-8023
Phone (317) 856-5677

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Indiana, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Aug 5, 2019 Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Aug 5, 2019 Accepting new patients

Locations

8411 Windfall Ln
Ste 130
Camby, IN 46113
Phone (317) 821-3500

14555 Hazel Dell Pkwy
Ste 120
Carmel, IN 46033
Phone (317) 706-2020

11720 Olio Rd
Fishers, IN 46037
Phone (317) 570-2778

9760 Lantern Rd
Fishers, IN 46037
Phone (317) 577-9200

980 Averitt Rd
Greenwood, IN 46143
Phone (317) 881-4143

7255 N Shadeland Ave
Indianapolis, IN 46250
Phone (317) 842-3937

6735 S Emerson Ave
Indianapolis, IN 46237
Phone (317) 783-1355

9745 Fall Creek Rd
Ste 400
Indianapolis, IN 46256
Phone (317) 578-0202

804 Broad Ripple Ave
Indianapolis, IN 46220
Phone (317) 257-5421

2902 W 86th St
Ste 160
Indianapolis, IN 46268
Phone (317) 228-9163

105 S Raceway Rd
Ste 100
Indianapolis, IN 46231
Phone (317) 273-8474

54 Monument Cir
Ste 125
Indianapolis, IN 46204
Phone (317) 631-1200

8170 Oaklandon Rd
#A
Indianapolis, IN 46236
Phone (317) 823-9985

5606 E Washington St
Indianapolis, IN 46219
Phone (317) 257-8385

2245 E Main St
Ste 100
Plainfield, IN 46168
Phone (317) 837-7800

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1565308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1356997993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 AVERITT RD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461439540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 AVERITT RD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461439540",
            "telephone_number": "317-881-4143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTHOFER",
        "first_name": "OLIVIA",
        "middle_name": "ROSE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-09",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004189A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

Verify at the official NPI Registry.