Individual provider Active NPI

Anthony Joseph Guadagno, O.D.

  • Optometrist
  • Schererville, IN
National Provider Identifier
1700966900
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002630A Issued in IN
Practice address
306 E US Highway 30
Schererville, IN 46375-2654
Phone
(219) 864-1300
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002630A IN Primary

Addresses

Primary practice location

306 E US Highway 30
Schererville, IN 46375-2654

Mailing address

306 E US Highway 30
Schererville, IN 46375-2654
Phone (219) 864-1300

Other identifiers 6

IdentifierTypeStateIssuer
GU010275OtherINCLARITY VISION
000000249419OtherINANTHEM/BCBS - ALL PLANS
200495500AMedicaidIN
24929OtherINSPECTERA
9379793OtherINPHCS
IN2630OtherINEYEMED

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
I20041109000942 IN Practitioner - Optometry 1153384201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

306 E US Hwy 30
Schererville, IN 46375-2654
Phone (219) 864-1300

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002630AINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony Guadagno, O.D., P.C. Optometrist CurrentSince Sep 1, 2010 Accepting new patients
SVS Vision Inc Optometrist PastSince Sep 1, 2010 Accepting new patients

Locations

306 E US Highway 30
Schererville, IN 46375
Phone (219) 864-1300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359936000000",
    "number": "1700966900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 E US HIGHWAY 30",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "463752654",
            "telephone_number": "219-864-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 E US HIGHWAY 30",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "463752654",
            "telephone_number": "219-864-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUADAGNO",
        "first_name": "ANTHONY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2013-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002630A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLARITY VISION",
            "identifier": "GU010275",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM/BCBS - ALL PLANS",
            "identifier": "000000249419",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200495500A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "24929",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "9379793",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "IN2630",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schererville, IN

Sources for this page

Verify at the official NPI Registry.