Individual provider Active NPI

Sanjana Dalal, OD

  • Optometrist
  • Munster, IN
National Provider Identifier
1477442929
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004597A Issued in IN
Practice address
630 Ridge Rd
Munster, IN 46321-1610
Phone
(219) 836-1738
NPI assigned
Jun 30, 2025
Last updated
Jun 30, 2025By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18004597A IN Primary

Addresses

Primary practice location

630 Ridge Rd
Munster, IN 46321-1610

Mailing address

630 Ridge Rd
Munster, IN 46321-1610

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
I20250904000656 IN Practitioner - Optometry 2365944980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gailmard Eye Center LLCGroup PAC ID 3577637974, 3 clinicians

Practice addresses (Care Compare)

630 Ridge Rd
Munster, IN 46321-1610
Phone (219) 836-1738

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gailmard Eye Center LLC Optometrist CurrentSince Jul 30, 2025 Accepting new patients

Locations

630 Ridge Rd
Munster, IN 46321
Phone (219) 836-1738

Organizations & group practices 1

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": "1751241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1477442929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 RIDGE RD",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 RIDGE RD",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211610",
            "telephone_number": "219-836-1738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALAL",
        "first_name": "SANJANA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-06-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004597A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.