Individual provider Active NPI

Walter H. Egenmaier, O.D.

  • Optometrist
  • Evansville, IN
National Provider Identifier
1609878990
Registry record updated Sep 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002611 Issued in IN
Practice address
101 NW 1St St
Suite 112
Evansville, IN 47708-1259
Phone
(812) 426-2020
Fax
(812) 426-2828
NPI assigned
Jun 1, 2005
Last updated
Sep 3, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002611 IN Primary
Optometrist 152W00000X 1000DT KY
Optometrist 152W00000X 1235 GA

Addresses

Primary practice location

101 NW 1St St
Suite 112
Evansville, IN 47708-1259

Mailing address

101 NW 1St St
Suite 112
Evansville, IN 47708-1259
Phone (812) 426-2020

Other identifiers 6

IdentifierTypeStateIssuer
4544563OtherINAETNA
87793OtherINANTHEM
100377200MedicaidIN
839180OtherINMEDICARE
410021835OtherINPALMENTO GBA
77340404MedicaidKY

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
I20071211000684 IN Practitioner - Optometry 2264521434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyecare Consultants LLPGroup PAC ID 2163319864, 3 clinicians

Practice addresses (Care Compare)

101 NW 1St St
Suite 112
Evansville, IN 47708-1259
Phone (812) 426-2020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.2 of 100Reported as group
Quality
99.56
Improvement activities
40
Cost
74.59

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1235GAMDAddiction (Substance Use Disorder) Counselor
18002611INMDOptometrist
1000DTKYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Norman D. Radtke, MD, PSC PastSince Jan 3, 2019 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: walteregenmaier@eccs.updoxdirect.com

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315008000000",
    "number": "1609878990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NW 1ST ST",
            "address_2": "SUITE 112",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477081259",
            "telephone_number": "812-426-2020",
            "fax_number": "812-426-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NW 1ST ST",
            "address_2": "SUITE 112",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477081259",
            "telephone_number": "812-426-2020",
            "fax_number": "812-426-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGENMAIER",
        "first_name": "WALTER",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2011-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002611",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1000DT",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1235",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4544563",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "87793",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100377200",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "839180",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMENTO GBA",
            "identifier": "410021835",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77340404",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.