Northeast Optical

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

01036129A Issued in IN

Legal business name

NORTHEAST OPTICAL

Practice address

2815 E 38TH St
Indianapolis, IN 46218-1229

Phone

(317) 547-5525

Fax

(317) 543-0948

NPI assigned

Apr 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Linda Fundenberger, M.D.

Title

Owner

Phone

(317) 547-5525

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Linda Fundenberger MD Other name

Locations

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371772800000",
    "number": "1669692190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 E 38TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462181229",
            "telephone_number": "317-547-5525",
            "fax_number": "317-543-0948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 E 38TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462181229",
            "telephone_number": "317-547-5525",
            "fax_number": "317-543-0948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2013-06-21",
        "status": "A",
        "authorized_official_last_name": "FUNDENBERGER",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-547-5525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "01036129A",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "IN",
            "license": "01036129A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100176610A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Linda Fundenberger MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Durable Medical Equipment & Medical Supplies in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.