Andrea Bowmar, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004472 Issued in MI

Practice address

1421 S 11TH St
Niles, MI 49120-4201

Phone

(269) 684-1330

Fax

(269) 684-3353

NPI assigned

Jun 10, 2006

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, MI2 enrollments

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 2

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 and National Provider Directory roles.

• Myeyedr Optometry of Michigan, LLC

  • Optometrist
  • Shelby Township, MI
  • NPI 1639723596

  MI, Optometrist

  Medicare reassignment NPD
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Lebanon, IN
  • NPI 1083100424

  IN, Optometrist

  Medicare reassignment NPD
• Myeyedr Optometry of Michigan, LLC

  • Optometrist
  • Niles, MI
  • NPI 1053996579
  NPD
• Myeyedr Optometry of Michigan, LLC

  • Optometrist
  • Clarkston, MI
  • NPI 1215753553
  NPD
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Elkhart, IN
  • NPI 1427633999
  NPD
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Munster, IN
  • NPI 1922974526
  NPD
• Christopher J. Wolf, OD, Inc

  • Optometrist
  • South Bend, IN
  • NPI 1023069283
  NPD (past)
• Northern Indiana Optometrists, PC

  • Optometrist
  • South Bend, IN
  • NPI 1841215738
  NPD (past)

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1891736617",
    "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": "1421 S 11TH ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491204201",
            "telephone_number": "269-684-1330",
            "fax_number": "269-684-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAR",
        "first_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004472",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002528",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100341250",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea J Bontrager, LCSW
• Mendy Boocher, OTR
• Sharon Diane Bouhaja, NP
• Laurel Christine Bourgeois, MSSA LISW-S,LCSW
• Michele K Bowen, LMSW
• Morgan R Bramlett, MS, CCC-SLP
• Bridges Health Services
• Kourtney Britton
• Robert Britton, MD
• Samantha Brousseau

• All providers in Niles, MI
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.