Christina Marie Mummert, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18003334A Issued in IN

Practice address

14413 Illinois Rd
Suite C
Fort Wayne, IN 46814-9714

Phone

(260) 616-0184

Fax

(855) 271-9517

NPI assigned

Oct 10, 2005

Last updated

Dec 16, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Envision Eye Care LLCGroup PAC ID 3375711799, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Envision Eye Care LLC

  dba Envision Eye Care and Eyewear Gallery

  • Optometrist
  • Fort Wayne, IN
  • NPI 1811280076
  Medicare reassignment Care Compare group NPD Authorized official
• Fowle Eyecare Associates PLC

  • Optometrist
  • Rockford, MI
  • NPI 1780888081
  NPD (past)
• Personaleyes Vision Care LLC

  • Optometrist
  • Grand Rapids, MI
  • NPI 1215024450
  NPD (past)

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1821086380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14413 ILLINOIS RD",
            "address_2": "SUITE C",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468149714",
            "telephone_number": "260-616-0184",
            "fax_number": "855-271-9517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14413 ILLINOIS RD",
            "address_2": "SUITE C",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468149714",
            "telephone_number": "260-616-0184",
            "fax_number": "855-271-9517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUMMERT",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-10",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003334A",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004071",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "410029181",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert FB Muller, M.D.
• Amanda Mullins, LPN
• Lauren M Mullins, RD
• Tracy E Mullins, NP
• Derek Mumaw, DPT
• Syed R. Mumtaz, M.D.
• Ankita Mundh
• Andrea Mundt, PHARMD
• Mungovan Chiropractic PC
• Michael Thomas Mungovan, DC

• Optometrist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.