Organization Active NPI

Midwest Eye Consultants, P.C.

  • Optometrist
  • Rochester, IN
National Provider Identifier
1437112059
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
56000164A Issued in IN
Legal business name
MIDWEST EYE CONSULTANTS, P.C.
Doing business as
Midwest Eye Consultants #29
Practice address
2260 Main St
Rochester, IN 46975-2107
Phone
(574) 223-3916
Fax
(574) 223-2965
NPI assigned
Apr 7, 2006
Organization subpart
Yes
Parent organization
MIDWEST EYE CONSULTANTS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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

Authorized official

Name
Gregory Garner
Title
Pres./Ceo
Phone
(260) 569-9550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 56000164A IN Primary

Addresses

Primary practice location

2260 Main St
Rochester, IN 46975-2107

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
200409010AMedicaidIN

Other names 1

  • Midwest Eye Consultants #29 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
15D2147584Midwest Eye Consultants #292260 Main St, Rochester, IN 46975Certificate of waiverApr 22, 2028

National Provider Directory

National Provider Directory
Part of
Garner Trump Eye Care

Locations

712 Cameron Woods Dr
Angola, IN 46703
Phone (260) 665-3240

374 Indian Boundary Rd
Chesterton, IN 46304
Phone (219) 395-1575

5319 S Emerson Ave
Indianapolis, IN 46237
Phone (317) 755-2254

611 E Douglas Rd
Ste 102
Mishawaka, IN 46545
Phone (574) 271-1114

Practitioners & affiliated clinicians

Practitioners 2

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": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353369600000",
    "number": "1437112059",
    "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": "260-569-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 MAIN ST",
            "city": "ROCHESTER",
            "state": "IN",
            "postal_code": "469752107",
            "telephone_number": "574-223-3916",
            "fax_number": "574-223-2965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST EYE CONSULTANTS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIDWEST EYE CONSULTANTS, P.C.",
        "enumeration_date": "2006-04-07",
        "last_updated": "2012-11-20",
        "status": "A",
        "authorized_official_last_name": "GARNER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "PRES./CEO",
        "authorized_official_telephone_number": "260-569-9550"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "56000164A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200409010A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Eye Consultants #29",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rochester, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; 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.