Matthew Michael Fornefeld, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

IN01034586 Issued in IN

Practice address

481 S Landmark Ave
Bloomington, IN 47403-5005

Phone

(812) 331-8181

Fax

(812) 331-8180

NPI assigned

Nov 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Indiana University School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mission Cataract and LasikGroup PAC ID 1254861198, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peterson Regional Medical Center Hospital, Kerrville, TX, CCN 450007

Merit-based Incentive Payment System (MIPS)

Final score

22.73 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

75.78

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Mission Cataract & Lasik

  • Ophthalmology Physician
  • Kerrville, TX
  • NPI 1043020019
  Medicare reassignment Care Compare group NPD
• Clariti Inc.

  • Ophthalmologic Surgery Clinic/Center
  • Bloomington, IN
  • NPI 1073708483
  NPD Authorized official
• Lasik San Antonio

  • Cornea and External Diseases Specialist Physician
  • Kerrville, TX
  • NPI 1083315014
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sid Peterson Memorial Hospital

  • Rural Acute Care Hospital
  • Kerrville, TX
  • NPI 1790782704
  Care Compare affiliation

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1881676807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035005",
            "telephone_number": "812-331-8181",
            "fax_number": "812-331-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035005",
            "telephone_number": "812-331-8181",
            "fax_number": "812-331-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORNEFELD",
        "first_name": "MATTHEW",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "IN01034586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Ford, MSW
• Keri Leigh Ford, RBT
• Sierra Ford, PA
• Forefront Dermatology, S.C.
• Sydney Forler, RBT
• Tynen Forrest
• Kendra Rae Foster, FNP
• Ronald David Foster, RPH
• Sarah Mae Foster
• Teresa R. Foster, L.C.S.W.

• Ophthalmology Physician in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Ophthalmology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.