Bastin Optometric Eye Clinic
Organization Active NPI Optometrist · Hopkinsville, KY
NPI 1043487515 · NPPES record last updated Jun 19, 2008
Key facts
- NPI
- 1043487515
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 1164 DT (KY)
- Legal business name
- BASTIN OPTOMETRIC EYE CLINIC
- Practice address
- 1016 S Main St
Hopkinsville, KY 42240-2010 - Phone
- (270) 886-2293
- Fax
- (270) 886-0399
- NPI assigned
- May 13, 2008
- Organization subpart
- No
Authorized official
- Name
- Robert Joseph Bastin, O.D.
- Title
- Optometrist
- Phone
- (270) 886-2293
Practitioners 3
-
Joseph Cory Bastin, O.D.
-
Robert Joseph Bastin, O.D.
-
Jeremy Tillman, OD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930092480 | KY | DME Supplier - Physician - Optometrist | 9436278181 | Practice locations: Hopkinsville, KY |
| O20180719002415 | KY | Part B Supplier - Clinic/Group Practice | 9436278181 |
Receives reassigned benefits from 3 practitioners Practice locations: Hopkinsville, KY |
National Provider Directory
Locations
220 W 18th St
Hopkinsville, KY 42240
Phone (270) 886-2293
1016 S Main St
Hopkinsville, KY 42240
Phone (270) 886-2273
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 1164 DT | KY | Yes |
Addresses
Primary practice location
1016 S Main St
Hopkinsville, KY 42240-2010
Mailing address
1016 S Main St
Hopkinsville, KY 42240-2010
Phone (270) 886-2293
Other providers in Hopkinsville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 19, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.