Individual provider Active NPI

Kora L Smith, OD

  • Optometrist
  • Indianapolis, IN
National Provider Identifier
1063908929
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004115 Issued in IN
Practice address
5319 S Emerson Ave
Indianapolis, IN 46237-1969
Phone
(317) 783-8700
Fax
(317) 783-5987
NPI assigned
Jul 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18004115 IN Primary

Addresses

Primary practice location

5319 S Emerson Ave
Indianapolis, IN 46237-1969

Mailing address

PO Box 549
Wabash, IN 46992-0549
Phone (260) 569-9550

Other identifiers 1

IdentifierTypeStateIssuer
300017948MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180712000561 IN Practitioner - Optometry 7012263684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Eye Consultants PCGroup PAC ID 2961399217, 71 clinicians

Practice addresses (Care Compare)

2750 Central Ave
Columbus, IN 47201-3125
Phone (812) 372-4463

301 J St
La Porte, IN 46350-4734
Phone (219) 362-8923

5319 S Emerson Ave
Cataract and Later Institute Indianapolis
Indianapolis, IN 46237-1969
Phone (317) 783-8700

Merit-based Incentive Payment System (MIPS)

Final score
55.99 of 100Reported as group
Quality
31.67
Improvement activities
40
Cost
78.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18004115INMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Eye Consultants, P.C. Current Accepting new patients
Midwest Eye Consultants, P.C. Optometrist CurrentSince Aug 6, 2018 Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients
Major Hospital Past Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients
Midwest Eye Consultants P.C. Optometrist Past Accepting new patients

Locations

2750 Central Ave
#53
Columbus, IN 47201
Phone (812) 372-4463

5319 S Emerson Ave
Indianapolis, IN 46237
Phone (317) 755-2254

301 J St
#34
Laporte, IN 46350
Phone (219) 362-8923

301 J St
Laporte, IN 46350
Phone (219) 326-9569

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1063908929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469920549",
            "telephone_number": "260-569-9550",
            "fax_number": "260-569-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5319 S EMERSON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462371969",
            "telephone_number": "317-783-8700",
            "fax_number": "317-783-5987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KORA",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-03",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300017948",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.