Individual provider Active NPI

D Penn Moody, O.D.

  • Optometrist
  • Indianapolis, IN
National Provider Identifier
1952369282
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18001808B Issued in IN
Practice address
8936 Southpointe Dr
Suite C-5
Indianapolis, IN 46227-7507
Phone
(317) 883-1122
Fax
(317) 883-1139
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18001808B IN Primary

Addresses

Primary practice location

8936 Southpointe Dr
Suite C-5
Indianapolis, IN 46227-7507

Mailing address

8936 Southpointe Dr
Suite C-5
Indianapolis, IN 46227-7507
Phone (317) 883-1122

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
I20050826000463 IN Practitioner - Optometry 9537190954

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18001808BINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Crosstown Eyecare LLC Optometrist PastSince Jan 1, 2009 Accepting new patients

Organizations & group practices 1

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1952369282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8936 SOUTHPOINTE DR",
            "address_2": "SUITE C-5",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462277507",
            "telephone_number": "317-883-1122",
            "fax_number": "317-883-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8936 SOUTHPOINTE DR",
            "address_2": "SUITE C-5",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462277507",
            "telephone_number": "317-883-1122",
            "fax_number": "317-883-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "D",
        "middle_name": "PENN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001808B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.