Individual provider Active NPI

Timothy Harreld Troutman Jr., OD

  • Optometrist
  • Huntingburg, IN
National Provider Identifier
1821079005
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003367 Issued in IN
Practice address
303 13TH St
Huntingburg, IN 47542-9269
Phone
(812) 683-4443
Fax
(812) 683-5409
NPI assigned
Nov 7, 2005
Last updated
Jun 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 16460T KY
Optometrist 152W00000X 18003367 IN Primary

Addresses

Primary practice location

303 13TH St
Huntingburg, IN 47542-9269

Mailing address

PO Box 360
Huntingburg, IN 47542-0360
Phone (812) 683-4443

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
I20050802001370 IN Practitioner - Optometry 5597793216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Eyecare Associates, L.L.P.Group PAC ID 4789612409, 3 clinicians

Practice addresses (Care Compare)

303 E 13TH St
Huntingburg, IN 47542-9269
Phone (812) 683-4443

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery80

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18003367INMDOptometrist
16460TKYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Talley Medical-Surgical Eye Care Associates PC Optometrist CurrentSince Mar 1, 2020 Accepting new patients
Professional Eyecare Associates, L.L.P. Optometrist CurrentSince Jul 19, 2005 Accepting new patients
Aeg Kentucky Professional, PLLC Optometrist PastSince Apr 20, 2024 Accepting new patients

Locations

303 E 13th St
Huntingburg, IN 47542
Phone (812) 683-4443

515 W 6th St
Jasper, IN 47546
Phone (812) 401-3937

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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1821079005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 360",
            "city": "HUNTINGBURG",
            "state": "IN",
            "postal_code": "475420360",
            "telephone_number": "812-683-4443",
            "fax_number": "812-683-5409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 13TH ST",
            "city": "HUNTINGBURG",
            "state": "IN",
            "postal_code": "475429269",
            "telephone_number": "812-683-4443",
            "fax_number": "812-683-5409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROUTMAN",
        "first_name": "TIMOTHY",
        "middle_name": "HARRELD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "16460T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntingburg, IN

Sources for this page

Verify at the official NPI Registry.