MICHIANA EYE CENTER LLC NPI 1073671731

NPI Information

NPI: 1073671731
Provider Name: MICHIANA EYE CENTER LLC
Classification: Ophthalmology - 207W00000X
Entity Type: Organization
Address: 319 N NILES AVE # 100
SOUTH BEND, IN
ZIP 46617
Phone: (574) 282-2020

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NPI Details

MICHIANA EYE CENTER LLC is an ophthalmology in South Bend, 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. MICHIANA EYE CENTER LLC NPI is 1073671731. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

319 N NILES AVE # 100
SOUTH BEND, IN
ZIP 46617
Phone: (574) 282-2020
Fax: (574) 288-2020

The provider's authorized official is Kevin R Baxter .
The authorized official title is Owner/ophthalmologist and has the following contact phone number (574) 271-3939.

The enumeration date for this NPI number is 12/5/2006 and was last updated on 6/18/2018.

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 Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	2082S0099X	Plastic Surgery	Plastic Surgery Within the Head and Neck	No
2	332B00000X	Durable Medical Equipment & Medical Supplies		No
3	152W00000X	Optometrist		No
4	174400000X	Specialist		No
5	207W00000X	Ophthalmology		Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100092980	MEDICAID	INDIANA
2	204460	OTHER	INDIANA	MEDICARE PTAN
3	DA1131	OTHER	INDIANA	RAILROAD MEDICARE

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: 11/21/2025

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