Individual provider Active NPI

Ellyn M Lovett, O.D.

  • Optometrist
  • Valparaiso, IN
National Provider Identifier
1558468447
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002888 Issued in IN
Practice address
851 Eastport Centre Dr
Valparaiso, IN 46383-2909
Phone
(219) 464-8223
Fax
(219) 531-2356
NPI assigned
Sep 20, 2006
Last updated
Nov 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002888 IN Primary

Addresses

Primary practice location

851 Eastport Centre Dr
Valparaiso, IN 46383-2909

Mailing address

752 Wood Stream Xing
Valparaiso, IN 46385-2972
Phone (219) 476-0343

Other practice location 1

1003 S Edgewood Dr
Knox, IN 46534-8226
Phone (574) 772-2012

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
I20211014001764 IN Practitioner - Optometry 6002214418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Indiana Eye and Laser Center PCGroup PAC ID 5193701340, 6 clinicians

Practice addresses (Care Compare)

851 Eastport Centre Dr
Valparaiso, IN 46383-2909
Phone (219) 464-8223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002888INMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Indiana Eye & Laser Center PC Optometrist CurrentSince Nov 1, 2021 Accepting new patients
Vision Surgery and Laser Center of Indiana LLC CurrentSince Nov 21, 2021 Accepting new patients

Locations

1003 S Edgewood Dr
Knox, IN 46534
Phone (574) 722-4040

851 Eastport Centre Dr
Valparaiso, IN 46383
Phone (219) 464-8223

Organizations & group practices 2

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1558468447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "752 WOOD STREAM XING",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463852972",
            "telephone_number": "219-476-0343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 EASTPORT CENTRE DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832909",
            "telephone_number": "219-464-8223",
            "fax_number": "219-531-2356"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1003 S Edgewood Dr",
            "address_purpose": "LOCATION",
            "city": "Knox",
            "state": "IN",
            "postal_code": "465348226",
            "country_code": "US",
            "telephone_number": "574-772-2012",
            "fax_number": "574-772-2221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOVETT",
        "first_name": "ELLYN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.