Eye Physicians Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

50000605A Issued in IN

Legal business name

EYE PHYSICIANS INC

Practice address

66 W 2ND St
Peru, IN 46970-2159

Phone

(765) 472-2000

Fax

(765) 472-2923

NPI assigned

Nov 29, 2006

Last updated

Jan 28, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael R Wild, MDNPI 1437110541

Title

Owner

Phone

(765) 453-3777

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Eye Physicians Inc

  • Ophthalmology Physician
  • Logansport, IN
  • NPI 1669559761

  O20050505000278

  Same enrollment
• Eye Physicians Inc

  • Ophthalmology Physician
  • Kokomo, IN
  • NPI 1972670982

  O20050505000278

  Same enrollment

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael R Wild, MD

  • Ophthalmology Physician
  • Kokomo, IN
  • NPI 1437110541
  Authorized official Same address or phone
• Thomas J Chowattukunnel, MD

  • Ophthalmology Physician
  • Marion, IN
  • NPI 1043292337
  NPD
• Luis E Colon, MD

  • Ophthalmology Physician
  • Indianapollis, IN
  • NPI 1255391686
  NPD
• Robert B Dinn, MD

  • Ophthalmology Physician
  • Kokomo, IN
  • NPI 1376699348
  NPD

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1740357748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 S LAFOUNTAIN ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023801",
            "telephone_number": "765-453-3777",
            "fax_number": "765-453-6577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 W 2ND ST",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469702159",
            "telephone_number": "765-472-2000",
            "fax_number": "765-472-2923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE PHYSICIANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "WILD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-453-3777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "50000605A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100136020B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherif Elmasry
• Engaging Families, LLC
• Tara Engel, NP
• Nathan Epp, DO
• Katina A Everding, NP
• Rafik Farag, MD
• Margaret Farley Farley, LMHC
• Patricia Flores, DDS
• Bethany Foerg, LMFTA
• Emily Renee Foley, PHARMD

• Ophthalmology Physician in Peru, IN
• Providers in Peru, IN by specialty
• Ophthalmology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.