Individual provider Active NPI

David Phillip Sonnenburg, O.D.

  • Optometrist
  • Mishawaka, IN
National Provider Identifier
1760797120
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003642 Issued in IN
Practice address
230 E Day Rd Ste 100
Mishawaka, IN 46545-3408
Phone
(574) 271-3939
Fax
(574) 271-3941
NPI assigned
Aug 10, 2010
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010413 IL
Optometrist 152W00000X 18003642 IN Primary

Addresses

Primary practice location

230 E Day Rd Ste 100
Mishawaka, IN 46545-3408

Mailing address

230 E Day Rd
Ste 100
Mishawaka, IN 46545-3408
Phone (574) 271-3939

Other practice location 1

320 Meadow Ln
Plymouth, IN 46563-9394
Phone (574) 935-4480

Other practice location 2

2216 Cassopolis St
Elkhart, IN 46514-5133
Phone (574) 266-2111

Other practice location 3

319 N Niles Ave Ste 100
South Bend, IN 46617-2328
Phone (574) 282-2020

Other practice location 4

1747 Stafford Ct
Goshen, IN 46526-6542
Phone (574) 533-0100

Other identifiers 3

IdentifierTypeStateIssuer
201113290MedicaidIN
P01171205OtherINMEDICARE RAILROAD
2044600006OtherINPTAN

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
I20121025000009 IN Practitioner - Optometry 9537358312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michiana Eye Center LLCGroup PAC ID 3173595634, 13 clinicians

Practice addresses (Care Compare)

230 E Day Rd
Suite 100
Mishawaka, IN 46545-3408
Phone (574) 271-3939

Merit-based Incentive Payment System (MIPS)

Final score
91.16 of 100Reported as group
Quality
96.76
Improvement activities
40
Cost
74.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Michiana Eye Center LLC Optometrist Current Accepting new patients
Michiana Eye Center LLC Optometrist CurrentSince Aug 22, 2016 Accepting new patients
Michiana Eye Center LLC Optometrist Past Accepting new patients
Michiana Eye Center , LLC Optometrist Past Accepting new patients
Michiana Eye Center LLC Optometrist Past Accepting new patients
Eyecare Indiana II, P.C. Optometrist Past Accepting new patients

Locations

2216 Cassopolis St
Elkhart, IN 46514
Phone (574) 266-2111

1747 Stafford Ct
Goshen, IN 46526
Phone (574) 533-0100

230 E Day Rd
Ste 100
Mishawaka, IN 46545
Phone (574) 271-3939

320 Meadow Ln
Plymouth, IN 46563
Phone (574) 935-4480

319 N Niles Ave
#100
South Bend, IN 46617
Phone (574) 282-2020

Interoperability endpoints

  • Direct secure messaging: david.sonnenburg@direct.mecfps.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1760797120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E DAY RD",
            "address_2": "STE 100",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453408",
            "telephone_number": "574-271-3939",
            "fax_number": "574-271-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E DAY RD STE 100",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453408",
            "telephone_number": "574-271-3939",
            "fax_number": "574-271-3941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 Meadow Ln",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "IN",
            "postal_code": "465639394",
            "country_code": "US",
            "telephone_number": "574-935-4480",
            "fax_number": "574-941-2040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2216 Cassopolis St",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465145133",
            "country_code": "US",
            "telephone_number": "574-266-2111",
            "fax_number": "574-266-0555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "319 N Niles Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466172328",
            "country_code": "US",
            "telephone_number": "574-282-2020",
            "fax_number": "574-288-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1747 Stafford Ct",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "IN",
            "postal_code": "465266542",
            "country_code": "US",
            "telephone_number": "574-533-0100",
            "fax_number": "574-534-8088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONNENBURG",
        "first_name": "DAVID",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010413",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201113290",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01171205",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "2044600006",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.