Active NPI
Lance Bennett, OD
- Optometrist
- Angola, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 18004017A
- Practice address
- 1400 N Wayne St Ste D
Angola, IN 46703-2359 - Phone
- (260) 668-8881
- Fax
- (260) 665-6498
- NPI assigned
- Sep 22, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18004017A | IN | Primary |
Addresses
Primary practice location
1400 N Wayne St Ste D
Angola, IN 46703-2359
Mailing address
8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Elkhart | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230719003532 | IN | Practitioner - Optometry | 1557721743 | Reassigns benefits to 1 organization |
| I20230818003449 | MI | Practitioner - Optometry | 1557721743 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Myeyedr Optometry of Indiana LLC
Practice addresses (Care Compare)
1400 N Wayne St
Suite D
Angola, IN 46703-2359
Phone (260) 668-8881
208 W N St
Kendallville, IN 46755-1134
Phone (260) 349-1008
9760 Lantern Rd
Fishers, IN 46037-9612
Phone (317) 577-9200
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18004017A | IN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Myeyedr Optometry of Indiana, LLC | Optometrist | Current | Accepting new patients |
| Myeyedr Optometry of Michigan, LLC | Optometrist | Current | Accepting new patients |
| Myeyedr Optometry of Michigan, LLC | Optometrist | Current | Accepting new patients |
| Myeyedr Optometry of Indiana, LLC | Optometrist | Current | Accepting new patients |
| Myeyedr Optometry of Michigan, LLC | Optometrist | Current | Accepting new patients |
| Myeyedr Optometry of Indiana, LLC | Optometrist | Current | Accepting new patients |
| RX Optical Laboratories, Inc. | Optometrist | Past | Accepting new patients |
Locations
1400 N Wayne St
Ste F
Angola, IN 46703
Phone (260) 668-8881
1400 N Wayne St
Ste D
Angola, IN 46703
Phone (260) 668-8881
9760 Lantern Rd
Fishers, IN 46037
Phone (317) 577-9200
208 W North St
Kendallville, IN 46755
Phone (260) 349-1008
65 Columbia Ave E
Battle Creek, MI 49015
Phone (269) 342-0003
755 E Chicago St
Coldwater, MI 49036
Phone (517) 278-9004
800 S Brown St
Jackson, MI 49203
Phone (517) 787-8890
8614 Westwood Center Dr
Fl 9
Vienna, VA 22182
Organizations & group practices 15
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689033600000",
"number": "1962871806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8614 WESTWOOD CENTER DR FL 9",
"city": "VIENNA",
"state": "VA",
"postal_code": "221822442",
"telephone_number": "703-847-8899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 N WAYNE ST STE D",
"city": "ANGOLA",
"state": "IN",
"postal_code": "467032359",
"telephone_number": "260-668-8881",
"fax_number": "260-665-6498"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "LANCE",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-09-22",
"last_updated": "2023-07-11",
"certification_date": "2023-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "18004017A",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Elkhart",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Elkhart",
"address_1": "904 Parkway Ave",
"city": "Elkhart",
"state": "IN",
"country_code": "US",
"postal_code": "465169337",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Angola, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.