Evergreen Eye Clinic - Medicare Optometrist in Lagrange, IN

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Evergreen Eye Clinic is a medicare enrolled "Optometrist" provider in Lagrange, Indiana. Their current practice location is 201 W Wayne St, Lagrange, Indiana. You can reach out to their office (for appointments etc.) via phone at (260) 463-3421.

Evergreen Eye Clinic is licensed to practice in Indiana (license number 18002670A/B) and it also participates in the medicare program. Evergreen Eye Clinic is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1174740682.

Contact Information

Evergreen Eye Clinic
201 W Wayne St,
Lagrange, IN 46761-1850
(260) 463-3421
(260) 463-7347

Map and Direction




Healthcare Provider's Profile

Full NameEvergreen Eye Clinic
TypeFacility
SpecialityOptometrist
Location201 W Wayne St, Lagrange, Indiana
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1174740682
  • Provider Enumeration Date: 04/19/2007
  • Last Update Date: 02/27/2010
  Medicare PECOS Information:
  • PECOS PAC ID: 7012057086
  • Enrollment ID: O20091223000144

Medical Identifiers

Medical identifiers for Evergreen Eye Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1174740682NPI-NPPES
2605932505OtherINVISION SERVICE PLAN TOPEKA
5742334109OtherINVISION SERVICE PLAN SOUTH BEND
200097680DMedicaidIN
2604633421OtherINVISION SERVICE PLAN LAGRANGE
000000257711OtherINANTHEM BC/BS LAGRANGE
000000257712OtherINANTHEM BC/BS TOPEKA
000000635212OtherINANTHEM NWIELC KNOX
200097680EMedicaidIN
1639177793OtherINRICKY WEIDOW NPI
200097680CMedicaidIN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist 18002670A/B (Indiana)Primary
332H00000XEyewear Supplier 18002670A/B (Indiana)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Evergreen Eye Clinic acts as a billing entity for following providers:
Provider NameRicky L Weidow
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1639177793
PECOS PAC ID: 8921022328
Enrollment ID: I20091223000119

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Evergreen Eye Clinic is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Evergreen Eye Clinic
201 W Wayne St, Po Box 150,
Lagrange, IN 46761-1850

Ph: (260) 463-3421		Evergreen Eye Clinic
201 W Wayne St,
Lagrange, IN 46761-1850

Ph: (260) 463-3421

Reviews and Comments


Optometrist in Lagrange, IN

Dr. Ricky Lee Weidow, O.D.
Optometrist
Medicare: Accepting Medicare Assignments
Practice Location: 201 W Wayne St, Lagrange, IN 46761
Phone: 260-463-3421    Fax: 260-463-7347

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.