NPIMap

Organization Active NPI

Midwest Eye Consultants, P.C.

  • Ophthalmology Physician
  • Fort Wayne, IN
National Provider Identifier
1366199192
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MIDWEST EYE CONSULTANTS, P.C.
Practice address
7755 W Jefferson Blvd
Fort Wayne, IN 46804-4135
Phone
(260) 459-8400
NPI assigned
Mar 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Authorized official

Name
Cathy Garrett
Title
Coo
Phone
(260) 569-9550

Specialties & licenses 2

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

Addresses

Primary practice location

7755 W Jefferson Blvd
Fort Wayne, IN 46804-4135

Mailing address

PO Box 549
Wabash, IN 46992-0549

Other identifiers 1

IdentifierTypeStateIssuer
200190920BMedicaidIN

Other names 1

  • Cataract and Laser Institute Fort Wayne #26 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040302000158 IN Part B Supplier - Clinic/Group Practice 2961399217 Receives reassigned benefits from 100 practitioners
This NPI is an additional NPI on the enrollment

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2263303Cataract and Laser Institute Fort Wayne #267755 W Jefferson Blvd, Fort Wayne, IN 46804Certificate of waiverJun 26, 2028

National Provider Directory

National Provider Directory
Tax ID family
Garner Trump Eye Care28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Locations

7747 W Jefferson Blvd
#A
Fort Wayne, IN 46804
Phone (260) 459-8444

Practitioners & affiliated clinicians

Practitioners 10

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": "1646179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1366199192",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7755 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044135",
            "telephone_number": "260-459-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST EYE CONSULTANTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-03-02",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "GARRETT",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "260-569-9550"
    },
    "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": "200190920B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cataract and Laser Institute Fort Wayne #26",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.