Individual provider Active NPI

James Roy Knowles, M.D.

  • Ophthalmology Physician
  • Beavercreek, OH
National Provider Identifier
1053306001
Registry record updated Feb 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
35-08-5811-K Issued in OH
Practice address
4235 Indian Ripple Rd
Ste 100
Beavercreek, OH 45440-3247
Phone
(937) 427-2020
Fax
(937) 429-1144
NPI assigned
Sep 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 35-08-5811-K OH Primary
Ophthalmology Physician 207W00000X 42080 TN

Addresses

Primary practice location

4235 Indian Ripple Rd
Ste 100
Beavercreek, OH 45440-3247

Mailing address

4235 Indian Ripple Rd
Ste 100
Beavercreek, OH 45440-3247
Phone (937) 427-2020

Other identifiers 2

IdentifierTypeStateIssuer
3000265MedicaidTN
2574478MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050721000193 OH Practitioner - Ophthalmology 7719914704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Mayo Medical School, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stahl Vision IncGroup PAC ID 3476458167, 4 clinicians

Practice addresses (Care Compare)

4235 Indian Ripple Rd
Suite 100
Beavercreek, OH 45440-3265
Phone (937) 427-2020

Merit-based Incentive Payment System (MIPS)

Final score
22.03 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
73.42

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
42080TNMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stahl Vision Inc Ophthalmology CurrentSince Jul 1, 2005 Accepting new patients
Eye Care Centers PLLC Past Accepting new patients
Eye Care Centers PLLC Ophthalmology Past Accepting new patients

Locations

4235 Indian Ripple Rd
Ste 110
Dayton, OH 45440
Phone (937) 427-7800

4235 Indian Ripple Rd
Ste 100
Dayton, OH 45440
Phone (937) 427-2020

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202428800000",
    "number": "1053306001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 INDIAN RIPPLE RD",
            "address_2": "STE 100",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454403247",
            "telephone_number": "937-427-2020",
            "fax_number": "937-429-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 INDIAN RIPPLE RD",
            "address_2": "STE 100",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454403247",
            "telephone_number": "937-427-2020",
            "fax_number": "937-429-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOWLES",
        "first_name": "JAMES",
        "middle_name": "ROY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2008-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35-08-5811-K",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "42080",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3000265",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2574478",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.