Individual provider Active NPI

Matthew E Evans, O.D.

  • Optometrist
  • Lafayette, IN
National Provider Identifier
1922085513
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002813 Issued in IN
Practice address
3829 Union St
Lafayette, IN 47905-4454
Phone
(765) 447-4951
Fax
(765) 447-4834
NPI assigned
Dec 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002813 IN Primary

Addresses

Primary practice location

3829 Union St
Lafayette, IN 47905-4454

Mailing address

3829 Union St
Lafayette, IN 47905-4454
Phone (765) 447-4951

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
I20101117000748 IN Practitioner - Optometry 6406826817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evans Eye Care IncGroup PAC ID 9830169234, 33 clinicians

Practice addresses (Care Compare)

1221 S Creasy LN
Suite a
Lafayette, IN 47905-7430
Phone (765) 447-4951

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Evans Eye Care Inc Optometrist CurrentSince Feb 2, 2002 Accepting new patients
Duane a Gillam Optometrist Past Accepting new patients
Carla R. Teso, OD, PC, Inc Optometrist Past Accepting new patients

Locations

211 S Perry St
Attica, IN 47918
Phone (765) 762-2652

1221 S Creasy Ln
Ste A
Lafayette, IN 47905
Phone (765) 447-4951

3526 Osborne Ln
Lafayette, IN 47909
Phone (765) 447-4951

3829 Union St
Lafayette, IN 47905
Phone (765) 447-4951

Interoperability endpoints

  • Direct secure messaging: matthew.evans@direct.revolutionehr.com

Organizations & group practices 3

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": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284422400000",
    "number": "1922085513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3829 UNION ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054454",
            "telephone_number": "765-447-4951",
            "fax_number": "765-447-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3829 UNION ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054454",
            "telephone_number": "765-447-4951",
            "fax_number": "765-447-4834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "MATTHEW",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2010-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.