Individual provider Active NPI

Blaine Michael Thorp, OD

  • Optometrist
  • Angola, IN
National Provider Identifier
1780319954
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004347A Issued in IN
Practice address
712 Cameron Woods Dr
Angola, IN 46703-8816
Phone
(260) 665-3240
NPI assigned
Jul 20, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18004347A IN Primary

Addresses

Primary practice location

712 Cameron Woods Dr
Angola, IN 46703-8816

Mailing address

1236 Quiet Harbor Dr
Fremont, IN 46737-7500
Phone (419) 356-3210

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
I20220729001344 IN Practitioner - Optometry 6901288554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Eye Consultants PCGroup PAC ID 2961399217, 71 clinicians

Practice addresses (Care Compare)

712 Cameron Woods Dr
Angola, IN 46703-8816
Phone (260) 665-3240

Merit-based Incentive Payment System (MIPS)

Final score
55.99 of 100Reported as group
Quality
31.67
Improvement activities
40
Cost
78.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Eye Consultants, P.C. Optometrist CurrentSince Jul 26, 2022 Accepting new patients
Midwest Eye Consultants, P.C. Current Accepting new patients
Midwest Eye Consultants, PC Optometrist CurrentSince Jul 26, 2022 Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients

Locations

712 Cameron Woods Dr
Angola, IN 46703
Phone (260) 665-3240

825 N Lincoln St
#12
Greensburg, IN 47240
Phone (812) 663-7222

301 J St
Laporte, IN 46350
Phone (219) 326-9569

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1780319954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1236 QUIET HARBOR DR",
            "city": "FREMONT",
            "state": "IN",
            "postal_code": "467377500",
            "telephone_number": "419-356-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 CAMERON WOODS DR",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467038816",
            "telephone_number": "260-665-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORP",
        "first_name": "BLAINE",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-07-20",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004347A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Angola, IN

Sources for this page

Verify at the official NPI Registry.