Lafayette Retina Clinic PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

01042571 Issued in MN

Legal business name

LAFAYETTE RETINA CLINIC PC

Practice address

100 Professional CT
Suite 101
Lafayette, IN 47905-5161

Phone

(765) 446-9446

Fax

(765) 447-9672

NPI assigned

Feb 14, 2008

Last updated

Feb 14, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gary E Schraut, MDNPI 1598731333

Title

Owner

Phone

(765) 446-9446

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gary E Schraut, MD

  • Ophthalmology Physician
  • Lafayette, IN
  • NPI 1598731333
  Medicare reassignment NPD Authorized official
• Denis Jusufbegovic, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Carmel, IN
  • NPI 1952544975
  NPD
• Raj K Maturi, MD

  • Retina Specialist (Ophthalmology) Physician
  • Carmel, IN
  • NPI 1366448631
  NPD (past)
• Stephen Joel Saxe, MD, FACS

  • Retina Specialist (Ophthalmology) Physician
  • Carmel, IN
  • NPI 1699750844
  NPD (past)
• Ankur Manilal Shah, M.D

  • Retina Specialist (Ophthalmology) Physician
  • Carmel, IN
  • NPI 1851590343
  NPD (past)

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202947200000",
    "number": "1568630325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PROFESSIONAL CT",
            "address_2": "SUITE 101",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055161",
            "telephone_number": "765-446-9446",
            "fax_number": "765-447-9672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PROFESSIONAL CT",
            "address_2": "SUITE 101",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055161",
            "telephone_number": "765-446-9446",
            "fax_number": "765-447-9672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAFAYETTE RETINA CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-14",
        "last_updated": "2008-02-14",
        "status": "A",
        "authorized_official_last_name": "SCHRAUT",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-446-9446",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "01042571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEGACY",
            "identifier": "1C18940",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lafayette Pain Care, P.C.
• Lafayette Pediatric Dentistry & Orthodontics
• Lafayette Podiatry Associates, P.C.
• Lafayette Radiology LLC
• Lafayette Regional Rehabilitation Hospital LLC
• Lafayette School Corporation
• Lafayette Surgery Center LLC
• Lafayette Vein and Vascular Center LLC (Lafayette Vein and Vascular)
• Lafayette Vision Center
• Lafayette Vision Center

• Ophthalmology Physician in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Ophthalmology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; 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.