Susan Lynn Eggebrecht, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

18002378A Issued in IN

Practice address

7750 W Jefferson Blvd
Fort Wayne, IN 46804

Phone

(260) 459-9595

Fax

(260) 459-9494

NPI assigned

Jan 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Indiana University - School of Optometry, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Ophthalmology P CGroup PAC ID 4688611692, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.97 of 100Reported as group

Quality

89.8

Improvement activities

40

Cost

76.84

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: seggebrecht@vco.intellechartdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northeast Ophthalmology P C

  • Ophthalmology Physician
  • Fort Wayne, IN
  • NPI 1265418719
  Medicare reassignment Care Compare group NPD
• Northeast Ophthalmology P C

  • Durable Medical Equipment & Medical Supplies
  • Fort Wayne, IN
  • NPI 1235846650

  Optometrist

  NPD

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1700857281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7750 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46804",
            "telephone_number": "260-459-9595",
            "fax_number": "260-459-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7750 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46804",
            "telephone_number": "260-459-9595",
            "fax_number": "260-459-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGGEBRECHT",
        "first_name": "SUSAN",
        "middle_name": "LYNN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002378A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100464730",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph A. Vincent Edwards, NP
• Lakyn Edwards
• Shelly J Edwards, LMFT
• Thomas G Edwards, PA-C
• Joseph W Egbert, CRNA
• Zachary Alan Eggebrecht, MD
• Janet M. Eggiman, LMFT
• Madison Eghigian
• Christina L Ehle-Fails, MS,LAT,ATC
• Lauren Elizabeth Ehle, LAT, ATC

• Optometrist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; 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.

Verify at the official NPI Registry.