Organization Active NPI

Eye to Eye LLC

  • Optometrist
  • Warsaw, IN
National Provider Identifier
1467042549
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYE TO EYE LLC
Practice address
2932 Frontage Rd
Warsaw, IN 46580-3914
Phone
(815) 735-8559
NPI assigned
Jan 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Authorized official

Name
Mr. Robert TeeterNPI 1902956493
Title
Member
Phone
(181) 532-5815

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

2932 Frontage Rd
Warsaw, IN 46580-3914

Mailing address

602 S Colfax St
Warsaw, IN 46580-4623
Phone (815) 735-8559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210218002349 IN Part B Supplier - Clinic/Group Practice 8628483914 Receives reassigned benefits from 2 practitioners
Practice locations: Warsaw, IN

National Provider Directory

National Provider Directory

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": "1611187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611187200000",
    "number": "1467042549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 S COLFAX ST",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465804623",
            "telephone_number": "815-735-8559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2932 FRONTAGE RD",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803914",
            "telephone_number": "815-735-8559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE TO EYE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-21",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A",
        "authorized_official_last_name": "TEETER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "181-532-5815",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.