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DR. DOUGLAS ERIC WIDMER O.D.
NPI 1710269550
Optometrist in South Bend, IN

Active since September 19, 2011PECOS EnrolledAccepts Medicare Assignment
4121 S. MICHIGAN STREET, SOUTH BEND, IN 46614(574) 291-9200(574) 299-4423 Get Directions Write a Review

NPPES record last updated: March 25, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Douglas Eric Widmer O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DOUGLAS ERIC WIDMER O.D. (NPI 1710269550) is an individual optometrist in South Bend, Indiana, licensed in Indiana (18003697A) and active in the NPI registry since September 2011. He is enrolled in Medicare PECOS and is a graduate of Ohio State University - College Of Optometry (2011).

NPPES Registry Identity

NPI1710269550
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. DOUGLAS ERIC WIDMERCredential: O.D.
Location Address4121 S. MICHIGAN STREETSouth Bend, IN 46614-2545
Mailing Address4121 S. Michigan StreetSouth Bend, IN 46614-2545 · (574) 291-9200 · Fax (574) 299-4423
Phone(574) 291-9200
Fax(574) 299-4423
Sole ProprietorNo
Medical School CMSOhio State University - College Of OptometryGraduated 2011
Enumeration DateSeptember 19, 2011
Last NPPES UpdateMarch 25, 2013
✔ NPI 1710269550 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in IN · 18003697A
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
4121 S. MICHIGAN STREET, South Bend, IN 46614
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Other Identifiers 2

Medicare PINM400067198IN
Medicaid201034430IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Douglas Eric Widmer O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8224200555
PECOS Enrollment IDI20140920000068
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46614 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$122.49 typical visit price
range $53.07 – $161.76
Typical copayment $30.62 (range $13.26 – $40.44)
Most-billed visit code 99204
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAWRENCE A SHINNEMAN O.D.
Optometrist
4121 S. MICHIGAN STREET
SOUTH BEND, IN 46614
St. Joseph County (574) 291-9200
EYECARE INDIANA LL, PC
Optometrist
4121 S. MICHIGAN STREET
SOUTH BEND, IN 46614
St. Joseph County (574) 291-9200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Douglas Widmer's NPI number?

The NPI number for Douglas Widmer is 1710269550. It was assigned to this individual provider in the NPPES registry on September 19, 2011.

Where is Douglas Widmer located?

Douglas Widmer practices at 4121 S. Michigan Street, South Bend, IN 46614. The listed phone number is (574) 291-9200.

What is Douglas Widmer's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Douglas Widmer enrolled in Medicare?

Yes. Douglas Widmer is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Douglas Widmer accept?

Health plans from CareSource and Providence Health Plan list Douglas Widmer as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Douglas Widmer was last updated on March 25, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.