Individual provider Active NPI

Tamara Latinovic

  • Optometrist
  • Portage, IN
National Provider Identifier
1417648692
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004401A Issued in IN
Practice address
6097 US Highway 6
Portage, IN 46368-5215
Phone
(219) 763-1538
NPI assigned
May 17, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18004401A IN Primary

Addresses

Primary practice location

6097 US Highway 6
Portage, IN 46368-5215

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other practice location 1

2106 Calumet Ave
Valparaiso, IN 46383-2708
Phone (219) 464-8200

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
I20230615000780 IN Practitioner - Optometry 0941668453 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crown Point EyecareGroup PAC ID 4183983489, 2 clinicians

Practice addresses (Care Compare)

10823 Broadway
Crown Point, IN 46307-7303
Phone (219) 310-8032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Jun 7, 2023 Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist Current Accepting new patients
Crown Point Eye Care Optometrist CurrentSince May 1, 2025 Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Jun 7, 2023 Accepting new patients

Locations

528 Indian Boundary Rd
Chesterton, IN 46304
Phone (219) 250-2470

10823 Broadway
Crown Point, IN 46307
Phone (219) 310-8032

1184 N Main St
Crown Point, IN 46307
Phone (219) 226-9571

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

279 W 80th Pl
Merrillville, IN 46410
Phone (219) 738-2180

6097 US Highway 6
Portage, IN 46368
Phone (219) 730-4559

2106 Calumet Ave
Valparaiso, IN 46383
Phone (219) 464-8200

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 4

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": "1684281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1417648692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6097 US HIGHWAY 6",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463685215",
            "telephone_number": "219-763-1538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2106 Calumet Ave",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463832708",
            "country_code": "US",
            "telephone_number": "219-464-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATINOVIC",
        "first_name": "TAMARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-17",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004401A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, IN

Sources for this page

Verify at the official NPI Registry.