NPIMap

Organization Active NPI

Eye Specialists of Indiana, PC

  • Optometrist
  • Indianapolis, IN
National Provider Identifier
1497891204
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
50003538A Issued in IN
Legal business name
EYE SPECIALISTS OF INDIANA, PC
Practice address
1901 N Meridian St
Indianapolis, IN 46202-1303
Phone
(317) 925-2200
NPI assigned
Jan 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Authorized official

Name
Wendy Kribley
Title
Billing Dept Manager
Phone
(317) 920-4575

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 50003538A IN Primary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X 50003538A IN

Addresses

Primary practice location

1901 N Meridian St
Indianapolis, IN 46202-1303

Mailing address

1901 N Meridian St
Indianapolis, IN 46202-1303
Phone (317) 925-2200

Other identifiers 1

IdentifierTypeStateIssuer
100436460AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050809000504 IN Part B Supplier - Clinic/Group Practice 5193754265 Receives reassigned benefits from 19 practitioners
1 other NPI on this enrollment
Practice locations: Indianapolis, IN; Terre Haute, IN

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1901 N Meridian St
Indianapolis, IN 46202
Phone (317) 925-2200

1055 S Hunt St
Terre Haute, IN 47803
Phone (317) 925-2200

Interoperability endpoints

  • Direct secure messaging: bsharp@esin.intellechartdirect.net
  • Direct secure messaging: rjohnston@esin.intellechartdirect.net
  • Direct secure messaging: blehman@esin.intellechartdirect.net
  • Direct secure messaging: mburkart@esin.intellechartdirect.net
  • Direct secure messaging: gkirk@esin.intellechartdirect.net
  • Direct secure messaging: wshultz@esin.intellechartdirect.net
  • Direct secure messaging: zrossman@esin.intellechartdirect.net
  • Direct secure messaging: slowdermilk@esin.intellechartdirect.net
  • Direct secure messaging: tmetzing@esin.intellechartdirect.net
  • Direct secure messaging: anoreika@esin.intellechartdirect.net
  • Direct secure messaging: jnguyen@esin.intellechartdirect.net
  • Direct secure messaging: pwalton@esin.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573084800000",
    "number": "1497891204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021303",
            "telephone_number": "317-925-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021303",
            "telephone_number": "317-925-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SPECIALISTS OF INDIANA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2019-11-07",
        "status": "A",
        "authorized_official_last_name": "KRIBLEY",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "BILLING DEPT MANAGER",
        "authorized_official_telephone_number": "317-920-4575"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "50003538A",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "50003538A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100436460A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; 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.