Individual provider Active NPI

Sean Deak

  • Optometrist
  • Columbus, IN
National Provider Identifier
1790898443
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003014A Issued in IN
Practice address
1130 Washington St
Columbus, IN 47201-5720
Phone
(812) 379-9893
Fax
(812) 379-9904
NPI assigned
Aug 16, 2006
Last updated
Jul 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18003014A IN Primary

Addresses

Primary practice location

1130 Washington St
Columbus, IN 47201-5720

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

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
I20200904000548 IN Practitioner - Optometry 1951728989 Reassigns benefits to 1 organization
Practice locations: Greensburg, IN

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Indiana LLCGroup PAC ID 5496091316, 82 clinicians

Practice addresses (Care Compare)

1130 Washington St
Columbus, IN 47201-5720
Phone (812) 379-9893

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Indiana, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Aug 23, 2021 Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Aug 23, 2021 Accepting new patients

Locations

1130 Washington St
Columbus, IN 47201
Phone (812) 379-9893

9760 Lantern Rd
Fishers, IN 46037
Phone (317) 577-9200

357 W Morgan St
Ste C
Spencer, IN 47460
Phone (812) 829-1254

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Interoperability endpoints

  • Direct secure messaging: sdeak021911@myeyedr.emadirect.md

Organizations & group practices 3

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1790898443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 WASHINGTON ST",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472015720",
            "telephone_number": "812-379-9893",
            "fax_number": "812-379-9904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAK",
        "first_name": "SEAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003014A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

Verify at the official NPI Registry.