Provider Demographics
NPI:1518996891
Name:BECK, STEVEN MATTHEW (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MATTHEW
Last Name:BECK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 NORTHWESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906-2268
Mailing Address - Country:US
Mailing Address - Phone:765-464-8573
Mailing Address - Fax:
Practice Address - Street 1:1850 SAGAMORE PKWY W
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47906-1368
Practice Address - Country:US
Practice Address - Phone:765-743-3132
Practice Address - Fax:765-743-2455
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003043A152W00000X
IN18003043B152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200254460Medicaid
IN200254460Medicaid
U71221Medicare UPIN