Tabitha G Temple, O.D.

Primary specialty

Pediatric OptometristTaxonomy code 152WP0200X

License

18002882 Issued in IN

Practice address

2250 N Pointe Dr
Warsaw, IN 46582-9042

Phone

(574) 267-3515

Fax

(574) 267-3259

NPI assigned

Sep 1, 2005

Reactivated

Apr 5, 2006

Last updated

Apr 20, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Indiana Professional PCGroup PAC ID 2365826179, 30 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aeg Indiana Professional PC

  • Optometrist
  • Warsaw, IN
  • NPI 1043944127
  Medicare reassignment Care Compare group NPD
• Dr Tabitha G Temple PC

  • Optometrist
  • Warsaw, IN
  • NPI 1851484125
  Authorized official Same address or phone

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1710971924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 N POINTE DR",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465829042",
            "telephone_number": "574-267-3515",
            "fax_number": "574-267-3259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 N POINTE DR",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465829042",
            "telephone_number": "574-267-3515",
            "fax_number": "574-267-3259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEMPLE",
        "first_name": "TABITHA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-01",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "deactivation_date": "2006-03-24",
        "reactivation_date": "2006-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "IN",
            "license": "18002882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200388760A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Optometrist in Warsaw, IN
• Providers in Warsaw, IN by specialty
• Pediatric Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; 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.