Individual provider Active NPI

Thomas D Morlan, O.D.

  • Optometrist
  • South Bend, IN
National Provider Identifier
1790787414
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003001A Issued in IN
Practice address
220 N Ironwood Dr
South Bend, IN 46615
Phone
(574) 233-2160
Fax
(574) 280-7355
NPI assigned
Aug 12, 2005
Last updated
Aug 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18003001A IN Primary

Addresses

Primary practice location

220 N Ironwood Dr
South Bend, IN 46615

Mailing address

PO Box 549
835 N. Cass St.
Wabash, IN 46992-0549
Phone (574) 233-2160

Other identifiers 2

IdentifierTypeStateIssuer
200238080BMedicaidIN
000000637898OtherINANTHEM

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
I20090603000639 IN Practitioner - Optometry 0941224349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1999
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)

220 N Ironwood Dr
Midwest Eye Consultants 42
South Bend, IN 46615-2518
Phone (574) 289-3937

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, PC Optometrist CurrentSince Jul 1, 2012 Accepting new patients
Midwest Eye Consultants, P.C. Current Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients
Midwest Eye Consultants P.C. Optometrist Past Accepting new patients
Vision Surgery and Laser Center of Indiana LLC PastSince Nov 21, 2021 Accepting new patients
Optometric Associates of South Bend Optometrist PastSince May 26, 2009 Accepting new patients

Locations

13197 State Road 23
Granger, IN 46530
Phone (574) 247-1500

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

301 J St
#34
Laporte, IN 46350
Phone (219) 362-8923

350 S Van Buren St
Ste B
Shipshewana, IN 46565
Phone (260) 765-7721

220 N Ironwood Dr
South Bend, IN 46615
Phone (574) 233-2626

220 N Ironwood Dr
#42
South Bend, IN 46615
Phone (574) 289-3937

Organizations & group practices 9

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": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1790787414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "address_2": "835 N. CASS ST.",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469920549",
            "telephone_number": "574-233-2160",
            "fax_number": "574-280-7355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N IRONWOOD DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "46615",
            "telephone_number": "574-233-2160",
            "fax_number": "574-280-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORLAN",
        "first_name": "THOMAS",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003001A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200238080B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000637898",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.