OSSIP OPTOMETRY, P.C NPI 1972520906

Optometrist in South Bend, IN

About OSSIP OPTOMETRY, P.C

Ossip Optometry, P.c is a provider in South Bend, IN. The NPI number assigned to this provider is 1972520906. The practitioner's primary taxonomy code is Optometrist (152W00000X). The provider is registered as an organization and their NPI record was last updated 3 years ago. Ossip Optometry, P.c operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as C&b Optical One.

NPI

1972520906

Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameOSSIP OPTOMETRY, P.C
Provider Location Address4121 S MICHIGAN ST SOUTH BEND, IN 46614 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address9795 CROSSPOINT BLVD STE 100 INDIANAPOLIS, IN 46256 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity TypeOrganization Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?N/A
Is Organization Subpart?No Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Other Organization NameC&B OPTICAL ONE Additional informationCallout TooltipProvider other organization name
The alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. Codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Other Name TypeDoing Business As (3)
Enumeration Date07-16-2006 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date10-13-2015 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Primary Taxonomy

Taxonomy Code152W00000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationOptometrist
TypeEye and Vision Services Providers
License No.18003467
License StateIN
Taxonomy DescriptionDoctors 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.

Business Address

OSSIP OPTOMETRY, P.C
4121 S MICHIGAN ST
SOUTH BEND, IN
ZIP 46614
Phone: (574) 291-9200
Fax: (574) 299-4423

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Mailing Address

OSSIP OPTOMETRY, P.C
9795 CROSSPOINT BLVD
STE 100
INDIANAPOLIS, IN
ZIP 46256
Phone: (317) 254-6480
Fax: (317) 259-8609

Authorized Official

Authorized Official NameDR. GREGG L OSSIP OD Additional informationCallout TooltipAuthorized official name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official TitleOWNER
Authorized Official Phone(317) 254-6480

193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
201052070MEDICAID (05)IN
6707150005MEDICARE NSC (07)IN
M100066611MEDICARE PIN (08)IN

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1659626976 JILLIAN J PALL OD
Individual
Optometrist4121 S MICHIGAN ST
SOUTH BEND, IN 46614
(574) 291-9200
1760733687EYECARE INDIANA II, PC
Organization
Optometrist4121 S MICHIGAN ST
SOUTH BEND, IN 46614
(574) 291-9200
Previous NPI
1972520898
Next NPI
1972520914