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ETHAN JAMES OD
NPI 1760226757
Optometrist in Mishawaka, IN

Active since June 24, 2024PECOS EnrolledAccepts Medicare Assignment
4020 EDISON LAKES PKWY, MISHAWAKA, IN 46545(574) 271-1114 Get Directions Write a Review

NPPES record last updated: June 24, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Ethan James Od NPPES

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

ETHAN JAMES OD (NPI 1760226757) is an individual optometrist in Mishawaka, Indiana, licensed in Indiana (18004511A) and active in the NPI registry since June 2024. He is enrolled in Medicare PECOS and is a graduate of Indiana University - School Of Optometry (2024).

NPPES Registry Identity

NPI1760226757
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameETHAN JAMESCredential: OD
Location Address4020 EDISON LAKES PKWYMishawaka, IN 46545-3420
Mailing Address1441 E Cherry StVermillion, SD 57069-2602
Phone(574) 271-1114
Sole ProprietorNo
Medical School CMSIndiana University - School Of OptometryGraduated 2024
Enumeration DateJune 24, 2024
NPPES CertifiedJune 24, 2024
✔ NPI 1760226757 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 · 18004511A
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.
4020 EDISON LAKES PKWY, Mishawaka, IN 46545
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ethan James Od 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 ID5799223806
PECOS Enrollment IDI20240820001041
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.

Medicare Billing Reassignment

Medicare enrollment records show Ethan James reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Midwest Eye Consultants, P.C.
0.8 mi
Ophthalmology
611 E DOUGLAS RD, SUITE 102
Mishawaka, IN 46545
  • Reassigned Medicare billing, Indiana enrollment
  • Medicare enrollment name: Midwest Eye Consultants PC
  • 103 clinicians in this Medicare group
NPI 1316240237 (574) 271-1114

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
55 services50 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
21 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46545 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

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

MIDWEST EYE CONSULTANTS, P.C.
Clinic/Center (Ambulatory Surgical)
4020 EDISON LAKES PKWY
MISHAWAKA, IN 46545
St. Joseph County (260) 569-9550

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 Ethan James's NPI number?

The NPI number for Ethan James is 1760226757. It was assigned to this individual provider in the NPPES registry on June 24, 2024.

Where is Ethan James located?

Ethan James practices at 4020 Edison Lakes Pkwy, Mishawaka, IN 46545. The listed phone number is (574) 271-1114.

What is Ethan James's specialty?

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

Is Ethan James enrolled in Medicare?

Yes. Ethan James 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.

Which organization bills Medicare for Ethan James's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ethan James reassigns Medicare benefits to Midwest Eye Consultants, P.C. (Mishawaka, IN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ethan James's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ethan James accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Blue Cross Blue Shield of Wyoming and 7 other insurers list Ethan James 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 Ethan James was last updated on June 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.