Individual provider Active NPI

Roy Hyman, OD

  • Optometrist
  • Louisville, KY
National Provider Identifier
1063587970
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
758DT Issued in KY
Practice address
5202 Preston Hwy
Louisville, KY 40213
Phone
(502) 966-2148
Fax
(502) 964-7500
NPI assigned
Nov 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 758DT KY Primary

Addresses

Primary practice location

5202 Preston Hwy
Louisville, KY 40213

Mailing address

5202 Preston Hwy
Louisville, KY 40213
Phone (502) 966-2148

Other identifiers 2

IdentifierTypeStateIssuer
77007581MedicaidKY
P00949013OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
758DTKYMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1063587970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5202 PRESTON HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40213",
            "telephone_number": "502-966-2148",
            "fax_number": "502-964-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5202 PRESTON HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40213",
            "telephone_number": "502-966-2148",
            "fax_number": "502-964-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYMAN",
        "first_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "758DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77007581",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00949013",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.