Active NPI
Reham Adel Baghdady, OD
- Optometrist
- Merrillville, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901005012
- Practice address
- 279 W 80TH PL
Merrillville, IN 46410-5491 - Phone
- (219) 738-2180
- NPI assigned
- Sep 6, 2016
- Last updated
- Mar 17, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18004011 | IN | |
| Optometrist | 152W00000X | 4901005012 | MI | Primary |
Addresses
Primary practice location
279 W 80TH PL
Merrillville, IN 46410-5491
Mailing address
362 E 125TH PL
Crown Point, IN 46307-7546
Phone (219) 789-9429
Other practice location 1
6800 S Westnedge Ave
Portage, MI 49002-3596
Phone (412) 772-8252
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18004011 | Other | IN | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18004011 | IN | MD | Optometrist |
| 4901005012 | MI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Empire Vision Center, Inc | Current | Accepting new patients | |
| Empire Vision Center Inc | Optometrist | Current | Accepting new patients |
| Campus Eye Group, LLC | Optometrist | Current | Accepting new patients |
| Campus Eye Group ASC, LLC | Current | Accepting new patients | |
| Campus Eye Group, LLC | Optometrist | Current | Accepting new patients |
Locations
1700 Whitehorse Hamilton Square Rd
Ste A1
Trenton, NJ 08690
Phone (215) 781-2020
2680 Delaware Ave
Ste C
Buffalo, NY 14216
Phone (716) 873-1241
560 Troy Schenectady Rd
#7
Latham, NY 12110
Phone (518) 783-0090
1498 Deer Park Ave
North Babylon, NY 11703
Phone (631) 242-6730
1930 South Rd
#105
Poughkeepsie, NY 12601
Phone (845) 298-3200
2590 W Ridge Rd
Rochester, NY 14626
Phone (585) 227-7150
2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 446-3145
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Ophthalmologic Surgery Clinic/Center
- Hamilton SQ, NJ
- NPI 1134101256
-
- Optometrist
- Hamilton Square, NJ
- NPI 1447232913
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1417404690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "362 E 125TH PL",
"city": "CROWN POINT",
"state": "IN",
"postal_code": "463077546",
"telephone_number": "219-789-9429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "279 W 80TH PL",
"city": "MERRILLVILLE",
"state": "IN",
"postal_code": "464105491",
"telephone_number": "219-738-2180"
}
],
"practiceLocations": [
{
"address_1": "6800 S Westnedge Ave",
"address_purpose": "LOCATION",
"city": "Portage",
"state": "MI",
"postal_code": "490023596",
"country_code": "US",
"telephone_number": "412-772-8252",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BAGHDADY",
"first_name": "REHAM",
"middle_name": "ADEL",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-06",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "18004011",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901005012",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "18004011",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Merrillville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.