Individual provider Active NPI

Julie M Weibert, O.D.

  • Optometrist
  • Indianapolis, IN
National Provider Identifier
1710036702
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003691B Issued in IN
Practice address
54 Monument Circle
Ste 125
Indianapolis, IN 46204
Phone
(317) 631-1200
Fax
(317) 631-1600
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046-009765 IL
Optometrist 152W00000X 346002316 IL
Optometrist 152W00000X 1726 KS
Optometrist 152W00000X 12871 CA
Optometrist 152W00000X 18003691A IN
Optometrist 152W00000X 18003691B IN Primary

Addresses

Primary practice location

54 Monument Circle
Ste 125
Indianapolis, IN 46204

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

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
I20110818000757 IN Practitioner - Optometry 1355376997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Indiana LLCGroup PAC ID 5496091316, 82 clinicians

Practice addresses (Care Compare)

54 Monument Cir
Suite 125
Indianapolis, IN 46204-3047
Phone (317) 631-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1726KSMDClinical Social Worker
12871CAMDOptometrist
046-009765ILMDOptometrist
346002316ILMDOptometrist
18003691AINMDOptometrist
18003691BINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Indiana, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Jan 8, 2019 Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Jan 8, 2019 Accepting new patients
Major Hospital Past Accepting new patients

Locations

11720 Olio Rd
Fishers, IN 46037
Phone (317) 570-2778

9760 Lantern Rd
Fishers, IN 46037
Phone (317) 577-9200

54 Monument Cir
Ste 125
Indianapolis, IN 46204
Phone (317) 631-1200

804 Broad Ripple Ave
Indianapolis, IN 46220
Phone (317) 257-5421

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 4

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1710036702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "866-795-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 MONUMENT CIRCLE",
            "address_2": "STE 125",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46204",
            "telephone_number": "317-631-1200",
            "fax_number": "317-631-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIBERT",
        "first_name": "JULIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009765",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "346002316",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1726",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12871",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003691A",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003691B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.