Individual provider Active NPI

Jonathan Vangessel, OD

  • Optometrist
  • Nappanee, IN
National Provider Identifier
1497315329
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004161A Issued in IN
Practice address
1752 E Market St
Nappanee, IN 46550-9216
Phone
(574) 773-4341
NPI assigned
Jun 13, 2019
Last updated
Jun 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18004161A IN Primary

Addresses

Primary practice location

1752 E Market St
Nappanee, IN 46550-9216

Mailing address

11520 E 300 N
Avilla, IN 46710-9636
Phone (260) 242-1310

Other practice location 1

103 Front St
North Manchester, IN 46962-1529
Phone (260) 982-8798

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
I20190715003554 IN Practitioner - Optometry 0941535850 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Indiana Professional PCGroup PAC ID 2365826179, 30 clinicians
Apple Eyecare FW Southwest LLCGroup PAC ID 8527455716, 2 clinicians
Manchester Eyecare LLCGroup PAC ID 8628302742, 2 clinicians

Practice addresses (Care Compare)

13813 State St
Grabill, IN 46741-2030
Phone (260) 627-1091

4626 W Jefferson Blvd
Fort Wayne, IN 46804-6897
Phone (260) 432-5502

901 State Rd 114
North Manchester, IN 46962-1967
Phone (260) 306-3937

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nappanee Family Eyecare, P.C. Optometrist CurrentSince Jul 1, 2019 Accepting new patients
Apple Eyecare FW Southwest LLC Optometrist CurrentSince Jan 1, 2025 Accepting new patients
Manchester Eyecare LLC Optometrist CurrentSince Jul 1, 2019 Accepting new patients
Hill Chiropractic LLC PastSince Jan 3, 2023 Accepting new patients

Locations

4626 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 432-0561

1752 E Market St
Nappanee, IN 46550
Phone (574) 773-4341

103 Front St
North Manchester, IN 46962
Phone (260) 306-0079

901 State Road 114 W
North Manchester, IN 46962
Phone (260) 306-3937

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": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1497315329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11520 E 300 N",
            "city": "AVILLA",
            "state": "IN",
            "postal_code": "467109636",
            "telephone_number": "260-242-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1752 E MARKET ST",
            "city": "NAPPANEE",
            "state": "IN",
            "postal_code": "465509216",
            "telephone_number": "574-773-4341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Front St",
            "address_purpose": "LOCATION",
            "city": "North Manchester",
            "state": "IN",
            "postal_code": "469621529",
            "country_code": "US",
            "telephone_number": "260-982-8798",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANGESSEL",
        "first_name": "JONATHAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-13",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004161A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nappanee, IN

Sources for this page

Verify at the official NPI Registry.