Individual provider Active NPI

Eric Robert Blickensderfer, OD

  • Optometrist
  • Huntington, IN
National Provider Identifier
1750102083
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004621A Issued in IN
Practice address
2880 Northpark Ave
Huntington, IN 46750-9700
Phone
(260) 356-6422
Fax
(260) 356-6423
NPI assigned
Oct 19, 2024
Last updated
Dec 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18004621A IN Primary

Addresses

Primary practice location

2880 Northpark Ave
Huntington, IN 46750-9700

Mailing address

2880 Northpark Ave
Huntington, IN 46750-9700
Phone (260) 356-6422

Other practice location 1

905 Manchester Ave
Wabash, IN 46992-1639
Phone (260) 563-0884

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
I20251022002658 IN Practitioner - Optometry 5193213031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marion Family Optometrists IncGroup PAC ID 5395803290, 7 clinicians

Practice addresses (Care Compare)

2880 Northpark Ave
Huntington, IN 46750-9700
Phone (260) 356-6422

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18004621AINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Marion Family Optometrists, Inc. Optometrist CurrentSince Aug 26, 2025 Accepting new patients
Marion Family Optometrists, Inc. Optometrist CurrentSince Aug 26, 2025 Accepting new patients

Locations

2880 Northpark Ave
Huntington, IN 46750
Phone (260) 356-6422

506 S Washington St
Marion, IN 46953
Phone (765) 662-6648

55 S Wabash St
Peru, IN 46970
Phone (765) 327-2037

905 Manchester Ave
Wabash, IN 46992
Phone (260) 563-0884

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1729296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1750102083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 NORTHPARK AVE",
            "city": "HUNTINGTON",
            "state": "IN",
            "postal_code": "467509700",
            "telephone_number": "260-356-6422",
            "fax_number": "260-356-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 NORTHPARK AVE",
            "city": "HUNTINGTON",
            "state": "IN",
            "postal_code": "467509700",
            "telephone_number": "260-356-6422",
            "fax_number": "260-356-6423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "905 Manchester Ave",
            "address_purpose": "LOCATION",
            "city": "Wabash",
            "state": "IN",
            "postal_code": "469921639",
            "country_code": "US",
            "telephone_number": "260-563-0884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLICKENSDERFER",
        "first_name": "ERIC",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-19",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004621A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, IN

Sources for this page

Verify at the official NPI Registry.