Individual provider Active NPI

David Wintergerst, O.D.

  • Optometrist
  • Odon, IN
National Provider Identifier
1790782936
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002037 Issued in IN
Practice address
101 E Elnora St
Odon, IN 47562-1125
Phone
(812) 636-8030
NPI assigned
Jul 1, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002037 IN Primary

Addresses

Primary practice location

101 E Elnora St
Odon, IN 47562-1125

Mailing address

101 E Elnora St
Odon, IN 47562-1125
Phone (812) 636-8030

Other identifiers 1

IdentifierTypeStateIssuer
100521500AMedicaidIN

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
I20111018000586 IN Practitioner - Optometry 2769594738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

101 E Elnora St
Odon, IN 47562-1125
Phone (812) 636-8030

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002037INMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Odon Optical, Inc. CurrentSince Sep 2, 2003 Accepting new patients

Locations

101 E Elnora St
Odon, IN 47562
Phone (812) 636-8030

Organizations & group practices 1

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": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1790782936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E ELNORA ST",
            "city": "ODON",
            "state": "IN",
            "postal_code": "475621125",
            "telephone_number": "812-636-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E ELNORA ST",
            "city": "ODON",
            "state": "IN",
            "postal_code": "475621125",
            "telephone_number": "812-636-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTERGERST",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100521500A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Odon, IN

Sources for this page

Verify at the official NPI Registry.