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NORTHEAST OPHTHALMOLOGY P C NPI 1255986162


NPI Information

NPI: 1255986162
Provider Name: NORTHEAST OPHTHALMOLOGY P C

Doing Business As: VISION CARE

Classification: Ophthalmology - 207W00000X
Entity Type: Organization

CLIA Number: 15D2275306

Address:
7750 W JEFFERSON BLVD STE B
FORT WAYNE, IN
ZIP 46804
Phone: (260) 459-9595
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NORTHEAST OPHTHALMOLOGY P C is an ophthalmology in Fort Wayne, IN. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. NORTHEAST OPHTHALMOLOGY P C NPI is 1255986162. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Vision Care.

The provider's business location address is:

7750 W JEFFERSON BLVD STE B
FORT WAYNE, IN
ZIP 46804-174
Phone: (260) 459-9595

The provider's authorized official is Barbara Schroeder .
The authorized official title is Partner and has the following contact phone number (260) 422-3937.

The CLIA number assigned to this NPI record is 15D2275306 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/7/2019 and was last updated on 11/5/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207W00000XOphthalmologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1300007703MEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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