NPIMap

Organization Active NPI

Neo Vision PC

  • Eyewear Supplier
  • Lafayette, IN
National Provider Identifier
1932176476
Registry record updated Oct 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
68000021A Issued in IN
Legal business name
NEO VISION PC
Practice address
2200 Elmwood Avenue
Suite D11
Lafayette, IN 47904
Phone
(765) 446-2814
Fax
(765) 447-2870
NPI assigned
Mar 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2010

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

Authorized official

Name
Dr. Robert Charles Loew, ODNPI 1316914856
Title
President
Phone
(765) 446-2814

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 68000021A IN Primary

Addresses

Primary practice location

2200 Elmwood Avenue
Suite D11
Lafayette, IN 47904

Mailing address

2200 Elmwood Avenue
Suite D11
Lafayette, IN 47904
Phone (765) 446-2814

Other identifiers 1

IdentifierTypeStateIssuer
200878340MedicaidIN

Other names 1

  • Neo Vision Optical Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050502000089 IN Part B Supplier - Clinic/Group Practice 4082653852 Receives reassigned benefits from 4 practitioners
Practice locations: Lafayette, IN
O20100930028709 IN DME Supplier - Physician - Optometrist 4082653852 Practice locations: Lafayette, IN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Neovision PC2200 Elmwood Ave, Lafayette, IN 47904-2347(765) 446-2814 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Oct 1, 2004

National Provider Directory

National Provider Directory

Locations

2200 Elmwood Ave
Lafayette, IN 47904
Phone (765) 446-2814

2200 Elmwood Ave
Ste D11
Lafayette, IN 47904
Phone (765) 446-2814

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287619200000",
    "number": "1932176476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 ELMWOOD AVENUE",
            "address_2": "SUITE D11",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "47904",
            "telephone_number": "765-446-2814",
            "fax_number": "765-447-2870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 ELMWOOD AVENUE",
            "address_2": "SUITE D11",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "47904",
            "telephone_number": "765-446-2814",
            "fax_number": "765-447-2870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEO VISION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-03",
        "last_updated": "2010-10-21",
        "status": "A",
        "authorized_official_last_name": "LOEW",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "765-446-2814",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "IN",
            "license": "68000021A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200878340",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neo Vision Optical",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.