NPIMap

Organization Active NPI

City Optical Co., Inc.

  • Optometrist
  • Indianapolis, IN
National Provider Identifier
1609045202
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
CITY OPTICAL CO., INC.
Practice address
2839 Lafayette Rd
Indianapolis, IN 46222-2147
Phone
(317) 924-1300
Fax
(855) 326-4293
NPI assigned
Feb 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Authorized official

Name
Dr. Larry S Tavel, MD
Title
President
Phone
(317) 924-1300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 18001649A IN
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

2839 Lafayette Rd
Indianapolis, IN 46222-2147

Mailing address

2839 Lafayette Rd
Indianapolis, IN 46222-2147
Phone (317) 924-1300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040128000867 IN Part B Supplier - Clinic/Group Practice 5597668574 Receives reassigned benefits from 58 practitioners
29 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Indianapolis, IN; Kokomo, IN; Lebanon, IN; Martinsville, IN; Merrillville, IN; Mooresville, IN; Muncie, IN; New Castle, IN…

Other NPIs on the same Medicare enrollment 29

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

View all 29

National Provider Directory

National Provider Directory
Tax ID family
City Optical Company26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635292800000",
    "number": "1609045202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2839 LAFAYETTE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462222147",
            "telephone_number": "317-924-1300",
            "fax_number": "317-924-3741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2839 LAFAYETTE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462222147",
            "telephone_number": "317-924-1300",
            "fax_number": "855-326-4293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OPTICAL CO., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A",
        "authorized_official_last_name": "TAVEL",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-924-1300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001649A",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 27, 2021; 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.