Individual provider Active NPI

Forrest Abram Keating, OD

  • Optometrist
  • Fort Wayne, IN
National Provider Identifier
1417525254
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004268A Issued in IN
Practice address
431 W Coliseum Blvd
Fort Wayne, IN 46805-1010
Phone
(260) 484-8516
Fax
(260) 484-8521
NPI assigned
Jun 17, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18004268A IN Primary

Addresses

Primary practice location

431 W Coliseum Blvd
Fort Wayne, IN 46805-1010

Mailing address

PO Box 549
Wabash, IN 46992-0549
Phone (260) 569-9550

Other practice location 1

9426 Lima Rd Ste C
Fort Wayne, IN 46818-8681
Phone (260) 489-5544

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
I20210618000842 IN Practitioner - Optometry 0749680312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Eye Consultants PCGroup PAC ID 2961399217, 71 clinicians

Practice addresses (Care Compare)

431 W Coliseum
Fort Wayne, IN 46805-1010
Phone (260) 484-8516

Merit-based Incentive Payment System (MIPS)

Final score
55.99 of 100Reported as group
Quality
31.67
Improvement activities
40
Cost
78.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Eye Consultants, P.C. Optometrist CurrentSince Jun 17, 2021 Accepting new patients
Midwest Eye Consultants, PC Optometrist CurrentSince Jun 17, 2021 Accepting new patients
Midwest Eye Consultants, P.C. Current Accepting new patients
Midwest Eye Consultants P.C. Optometrist Past Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients

Locations

750 N Grandstaff Dr
Auburn, IN 46706
Phone (260) 925-3116

1601 E Paulding Rd
Fort Wayne, IN 46816
Phone (260) 744-2273

9426 Lima Rd
Ste C
Fort Wayne, IN 46818
Phone (219) 489-5544

2874 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 490-1631

2001 Reed Rd
Fort Wayne, IN 46815
Phone (260) 424-5163

431 W Coliseum Blvd
Fort Wayne, IN 46805
Phone (260) 484-8516

825 N Lincoln St
#12
Greensburg, IN 47240
Phone (812) 663-7222

301 J St
Laporte, IN 46350
Phone (219) 326-9569

301 J St
#34
Laporte, IN 46350
Phone (219) 362-8923

Organizations & group practices 10

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": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1417525254",
    "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": "260-569-9244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 W COLISEUM BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468051010",
            "telephone_number": "260-484-8516",
            "fax_number": "260-484-8521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9426 Lima Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468188681",
            "country_code": "US",
            "telephone_number": "260-489-5544",
            "fax_number": "260-490-7725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEATING",
        "first_name": "FORREST",
        "middle_name": "ABRAM",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-17",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004268A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.