Individual provider Active NPI

Brooke Danielle Tobias, OD

  • Optometrist
  • Indianapolis, IN
National Provider Identifier
1427628668
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004283A Issued in IN
Practice address
1160 W Michigan St Ste 100
Indianapolis, IN 46202-5209
Phone
(317) 278-1470
NPI assigned
Jun 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 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 18004283A IN Primary

Addresses

Primary practice location

1160 W Michigan St Ste 100
Indianapolis, IN 46202-5209

Mailing address

65 N County Road 1800
West Point, IL 62380-2114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210713003023 IN Practitioner - Optometry 6002218070 Reassigns benefits to 1 organization
I20220713003758 IL Practitioner - Optometry 6002218070 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
Tim a Bengtson O.D., P.C.Group PAC ID 3678460920, 4 clinicians

Practice addresses (Care Compare)

820 E Jackson St
Macomb, IL 61455-2412
Phone (309) 833-4242

Merit-based Incentive Payment System (MIPS)

Final score
96.56 of 100Reported as group
Quality
89.58
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18004283AINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Optometrist CurrentSince Jun 30, 2021 Accepting new patients
Tim a Bengtson O.D., P.C. Optometrist CurrentSince Jul 1, 2022 Accepting new patients
Indiana University CurrentSince Jun 30, 2021 Accepting new patients
Indiana University Optometrist Past Accepting new patients

Locations

820 E Jackson St
Macomb, IL 61455
Phone (309) 343-1000

800 E Atwater Ave
Rm 263
Bloomington, IN 47405

1160 W Michigan St
Ste 100
Indianapolis, IN 46202
Phone (317) 278-1470

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": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1427628668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 N COUNTY ROAD 1800",
            "city": "WEST POINT",
            "state": "IL",
            "postal_code": "623802114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 W MICHIGAN ST STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025209",
            "telephone_number": "317-278-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIAS",
        "first_name": "BROOKE",
        "middle_name": "DANIELLE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004283A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.