Northside Eye Center LLC
NPI 1770266322ActiveOrganization· Optometrist· Fort Wayne, IN
Optometrist in Fort Wayne, Indiana, registered in NPPES in August 2023. The authorized official on file is Brandon Callow, OD, Optometrist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1770266322 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 10, 2023 |
| Last updated in NPPES | Mar 11, 2024 |
| Certified by provider | Mar 7, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IN) |
|---|
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All 152 optometrists in Fort Wayne · All optometrists in Indiana