Craig Michael Lichlyter, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18003657A Issued in IN

Practice address

781 E North St
Kendallville, IN 46755-1225

Phone

(260) 347-3458

Fax

(260) 347-4425

NPI assigned

Jul 29, 2010

Last updated

Aug 27, 2016By the provider in NPPES

Sex

Male

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DRS Roush and Will Optometrists IncGroup PAC ID 9830165026, 5 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.

• DRS. Roush & Will Optometrists Inc

  • Optometrist
  • Kendallville, IN
  • NPI 1578613295
  Medicare reassignment Care Compare group NPD
• DRS. Roush & Will Optometrists Inc

  • Eyewear Supplier
  • Albion, IN
  • NPI 1730451279

  Optometrist

  NPD
• Better Visions, P.C.

  • Optometrist
  • Leo, IN
  • NPI 1003902339
  NPD (past)
• Westrick Family Eye Care P C

  • Optometrist
  • Columbia City, IN
  • NPI 1376717017
  NPD (past)

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

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472256000000",
    "number": "1720392020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "781 E NORTH ST",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467551225",
            "telephone_number": "260-347-3458",
            "fax_number": "260-347-4425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 E NORTH ST",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467551225",
            "telephone_number": "260-347-3458",
            "fax_number": "260-347-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHLYTER",
        "first_name": "CRAIG",
        "middle_name": "MICHAEL",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-29",
        "last_updated": "2016-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003657A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200992180",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kroger Limited Partnership I (Kroger Pharmacy #418)
• Sabrina Kurian
• Molly Laisure
• Brian Lamar, MD
• Dawn Levin, PT
• Danielle Marie Likes
• Sarah Manjula Lobacz, MS, LMFT
• Longe Enterprises Corp
• Longe Optical
• Shaun Marshall Loveless, D.D.S.

• Optometrist in Kendallville, IN
• Providers in Kendallville, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2016; 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.