Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Michael John Rotheker, OD

Individual provider Optometrist · NPI 1316935208

Dr. Michael John Rotheker, OD is an Optometry in South Bend, Indiana. Graduated from Illinois College of Optometry at Chicago in 2001, 25 years ago. Practices with Boling Vision Center LLC, a 12-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
25
Trained at
Illinois College of Optometry at Chicago
Licensed in
IN
In the registry since
2005
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

17615 State Road 23
South Bend, IN 46635
Phone: (574) 234-7600
Fax: (574) 234-8408
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 18003124A (IN)

Record details

NPI number1316935208
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedOctober 13, 2005
Last updated in NPPESAugust 14, 2018
Mailing address4121 S. Michigan Street, South Bend, IN 46614-2545

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Graduated 2001 (25 years in practice)
Group practice Boling Vision Center Llc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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