Provider Type Icon

GROSSNICKLE EYE CENTER INC. NPI 1265436125


NPI Information

NPI: 1265436125
Provider Name: GROSSNICKLE EYE CENTER, INC.
Classification: Ophthalmology - 207W00000X
Entity Type: Organization

CLIA Number: 15D0357030

Address:
2251 DUBOIS DR
WARSAW, IN
ZIP 46580
Phone: (574) 269-2777
Get Directions

GROSSNICKLE EYE CENTER, INC. is an ophthalmology in Warsaw, 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. GROSSNICKLE EYE CENTER, INC. NPI is 1265436125. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2251 DUBOIS DR
WARSAW, IN
ZIP 46580-212
Phone: (574) 269-2777
Fax: (574) 371-4697

The provider's authorized official is Matthew C Ralstin .
The authorized official title is Owner and has the following contact phone number (574) 269-2777.

The CLIA number assigned to this NPI record is 15D0357030 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/9/2005 and was last updated on 3/5/2019.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207W00000XOphthalmology50001530AINDIANAYes

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
1200018500MEDICAIDINDIANA

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.