Individual provider Active NPI

Miccah Allyson Hoffman, O.D.

  • Optometrist
  • Terre Haute, IN
National Provider Identifier
1649316126
Registry record updated Jan 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003224 Issued in IN
Practice address
4684 S US Highway 41
Terre Haute, IN 47802-5404
Phone
(812) 232-4925
NPI assigned
Jan 30, 2007
Last updated
Jan 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18003224 IN Primary

Addresses

Primary practice location

4684 S US Highway 41
Terre Haute, IN 47802-5404

Mailing address

2022 E Lukes CT
Bloomington, IN 47401-9485
Phone (812) 219-7039

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
I20190221001394 IN Practitioner - Optometry 2466790258 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Indiana Professional PCGroup PAC ID 2365826179, 30 clinicians
Darla Heck Sacopulos PCGroup PAC ID 6901847169, 2 clinicians

Practice addresses (Care Compare)

26 N Brown Ave
Valley Vision Eye
Terre Haute, IN 47803-1523
Phone (812) 872-2020

4949 E Poplar Dr
Terre Haute, IN 47803-2434
Phone (812) 872-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18003224INMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Darla Heck Sacopulos PC Optometrist CurrentSince Jun 15, 2020 Accepting new patients
Bloomington Optometry LLC Optometrist CurrentSince Jun 29, 2025 Accepting new patients
Aeg Indiana Professional PC Optometrist Past Accepting new patients
Vision Mart Eye Center, Inc. PastSince Nov 24, 2019 Accepting new patients
Vision Mart Eye Center, Inc. Past Accepting new patients

Locations

4949 E Poplar Dr
Terre Haute, IN 47803
Phone (812) 872-2020

26 N Brown Ave
Terre Haute, IN 47803
Phone (812) 872-2020

Organizations & group practices 5

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1649316126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2022 E LUKES CT",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474019485",
            "telephone_number": "812-219-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4684 S US HIGHWAY 41",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478025404",
            "telephone_number": "812-232-4925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "MICCAH",
        "middle_name": "ALLYSON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.