Organization Active NPI

Eyecare Consultants LLP

  • Ophthalmology Physician
  • Evansville, IN
National Provider Identifier
1922061688
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYECARE CONSULTANTS LLP
Practice address
101 NW 1St St
Suite 112
Evansville, IN 47708-1259
Phone
(812) 426-2020
Fax
(812) 426-2828
NPI assigned
Apr 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2013

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

Authorized official

Name
Mr. Matthew M Boyer, MDNPI 1346245453
Title
Owner
Phone
(812) 426-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 18002611A IN
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

101 NW 1St St
Suite 112
Evansville, IN 47708-1259

Mailing address

101 NW 1St St
Suite 112
Evansville, IN 47708-1259
Phone (812) 426-2020

Other identifiers 3

IdentifierTypeStateIssuer
200309980MedicaidIN
CM8132OtherINPALMENTO GBA
15D2023475OtherINCLIA CERTIFICATE OF WAIVER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071211000519 IN Part B Supplier - Clinic/Group Practice 2163319864 Receives reassigned benefits from 3 practitioners
Practice locations: Evansville, IN

National Provider Directory

National Provider Directory

Locations

101 NW 1st St
Evansville, IN 47708
Phone (812) 426-2020

101 NW 1st St
Ste 112
Evansville, IN 47708
Phone (800) 643-8197

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379289600000",
    "number": "1922061688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NW 1ST ST",
            "address_2": "SUITE 112",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477081259",
            "telephone_number": "812-426-2020",
            "fax_number": "812-426-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NW 1ST ST",
            "address_2": "SUITE 112",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477081259",
            "telephone_number": "812-426-2020",
            "fax_number": "812-426-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE CONSULTANTS LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2013-09-16",
        "status": "A",
        "authorized_official_last_name": "BOYER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-426-2020",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002611A",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200309980",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMENTO GBA",
            "identifier": "CM8132",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA CERTIFICATE OF WAIVER",
            "identifier": "15D2023475",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.