Ricky W Baron, O.D.
Individual provider Active NPI Optometrist · Decatur, IN
NPI 1902893571 · NPPES record last updated May 1, 2018
Key facts
- NPI
- 1902893571
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 18001733B (IN)
- Practice address
- 710 S 13TH St
Decatur, IN 46733-1802 - Phone
- (260) 724-4318
- Fax
- (260) 724-9776
- NPI assigned
- Sep 29, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18001733B | IN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Eye Consultants, P.C. | Optometrist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18001733B | IN | Yes |
Addresses
Primary practice location
710 S 13TH St
Decatur, IN 46733-1802
Mailing address
PO Box 549
Wabash, IN 46992-0549
Phone (260) 569-9550
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300009935 | Medicaid | IN | |
| 100146650A | Medicaid | IN | |
| 000000084907 | Other | IN | ANTHEM BCBS |
| 5348017 | Other | IN | AETNA |
Other providers in Decatur, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.