Individual provider Active NPI

Joseph Michael Thallemer, O.D.

  • Optometrist
  • Warsaw, IN
National Provider Identifier
1578595336
Registry record updated Oct 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18001892A Issued in IN
Practice address
3301 E Center Street Ext
Warsaw, IN 46582-3909
Phone
(574) 269-3828
Fax
(574) 269-3848
NPI assigned
Jul 6, 2006
Last updated
Oct 15, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18001892A IN Primary
Corneal and Contact Management Optometrist 152WC0802X 18001892A IN
Low Vision Rehabilitation Optometrist 152WL0500X 18001892A IN

Addresses

Primary practice location

3301 E Center Street Ext
Warsaw, IN 46582-3909

Mailing address

3301 E Center Street Ext
Warsaw, IN 46582-3909
Phone (574) 269-3828

Other identifiers 1

IdentifierTypeStateIssuer
100157080AMedicaidIN

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
I20040902000007 IN Practitioner - Optometry 7810962776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mitchell Reinholt OD LLCGroup PAC ID 2264858588, 4 clinicians

Practice addresses (Care Compare)

3301 E Ctr St Ext
Warsaw, IN 46582-3909
Phone (574) 269-3828

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18001892AINMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph M. Thallemer, O.D., P.C. CurrentSince Jan 1, 1990 Accepting new patients
Mitchell Reinholt, OD, LLC Optometrist CurrentSince Jan 1, 2021 Accepting new patients

Locations

3301 E Center Street Ext
Warsaw, IN 46582
Phone (574) 269-3828

Organizations & group practices 3

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255564800000",
    "number": "1578595336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 E CENTER STREET EXT",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465823909",
            "telephone_number": "574-269-3828",
            "fax_number": "574-269-3848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 E CENTER STREET EXT",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465823909",
            "telephone_number": "574-269-3828",
            "fax_number": "574-269-3848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THALLEMER",
        "first_name": "JOSEPH",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2009-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001892A",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IN",
            "license": "18001892A",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "IN",
            "license": "18001892A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100157080A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, IN

Sources for this page

Verify at the official NPI Registry.