Individual provider Active NPI

Vincent Maniscalco, OD

  • Optometrist
  • Fort Wayne, IN
National Provider Identifier
1821781600
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1800439A Issued in IN
Practice address
3401 Lake Ave
Fort Wayne, IN 46805-5500
Phone
(260) 426-3095
NPI assigned
May 30, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1800439A IN Primary

Addresses

Primary practice location

3401 Lake Ave
Fort Wayne, IN 46805-5500

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
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
I20230719001782 IN Practitioner - Optometry 9335509587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2023
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)

105 S Raceway Rd
Suite 100
Indianapolis, IN 46231-1415
Phone (317) 273-8474

3902 E 82ND St
Indianapolis, IN 46240-2467
Phone (317) 595-8855

4335 E 82ND St
Suite 105
Indianapolis, IN 46250-1699
Phone (463) 403-6439

6735 S Emerson Ave
Indianapolis, IN 46237-3307
Phone (317) 783-1355

8890 E 116TH St
Suite 190
Fishers, IN 46038-2857
Phone (317) 913-0700

9745 Fall Creek Rd
Suite 400
Indianapolis, IN 46256-4730
Phone (317) 578-0202

9760 Lantern Rd
Fishers, IN 46037-9612
Phone (317) 577-9200

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1800439AINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Indiana, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Dec 29, 2025 Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Dec 29, 2025 Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist Past Accepting new patients

Locations

1921 E 53rd St
Anderson, IN 46013
Phone (765) 649-2278

13080 Grand Blvd
Ste 110
Carmel, IN 46032
Phone (317) 575-1133

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

3401 Lake Ave
Fort Wayne, IN 46805
Phone (260) 422-6396

6735 S Emerson Ave
Indianapolis, IN 46237
Phone (317) 783-1355

105 S Raceway Rd
Ste 100
Indianapolis, IN 46231
Phone (317) 273-8474

9745 Fall Creek Rd
Ste 400
Indianapolis, IN 46256
Phone (317) 578-0202

6985 W 38th St
Ste 100
Indianapolis, IN 46254
Phone (317) 243-0028

316 W 161st St
Westfield, IN 46074
Phone (317) 867-0555

1501 W Oak St
Ste 100
Zionsville, IN 46077
Phone (317) 873-4020

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 4

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": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1821781600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "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": "3401 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055500",
            "telephone_number": "260-426-3095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANISCALCO",
        "first_name": "VINCENT",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-30",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "1800439A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.