Active NPI
Annie Dong, OD, FAAO
- Optometrist
- Indianapolis, IN
National Provider Identifier
1639043136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 180004634A
- Practice address
- 2839 Lafayette Rd
Indianapolis, IN 46222-2147 - Phone
- (317) 924-1300
- Fax
- (317) 732-1144
- NPI assigned
- Sep 30, 2025
- Last updated
- Nov 2, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2025032431 | MO | |
| Optometrist | 152W00000X | 180004634A | IN | 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
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- State University of New York - State College Optometry, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2839 Lafayette Rd
Indianapolis, IN 46222-2193
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2025032431 | MO | MD | Optometrist |
Organizations & group practices 1
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": "1759190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1793577600000",
"number": "1639043136",
"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": "317-732-1144"
},
{
"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": "317-732-1144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONG",
"first_name": "ANNIE",
"credential": "OD, FAAO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-09-30",
"last_updated": "2026-11-02",
"certification_date": "2026-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "2025032431",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "180004634A",
"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 Nov 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.