Individual provider Active NPI

Matthew W. Baker, O.D.

  • Optometrist
  • Michigan City, IN
National Provider Identifier
1467587675
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002051B Issued in IN
Practice address
3901 Franklin St
Michigan City, IN 46360-7314
Phone
(219) 878-6668
Fax
(219) 878-1918
NPI assigned
Feb 21, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002051B IN Primary

Addresses

Primary practice location

3901 Franklin St
Michigan City, IN 46360-7314

Mailing address

207 Leeds Dr
Valparaiso, IN 46383-2422
Phone (219) 462-3679

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002051BINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher J. Wolf, OD, Inc Optometrist Past Accepting new patients
Eyecare Indiana LL, PC Optometrist Past Accepting new patients
Eyecare Indiana II, P.C. Optometrist Past Accepting new patients
Luxottica of America Inc Past Accepting new patients
Northern Indiana Optometrists, PC Optometrist Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1467587675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 LEEDS DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832422",
            "telephone_number": "219-462-3679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 FRANKLIN ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607314",
            "telephone_number": "219-878-6668",
            "fax_number": "219-878-1918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "MATTHEW",
        "middle_name": "W.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002051B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.