Individual provider Active NPI

Kimberly B Feder, O.D.

  • Optometrist
  • Fort Myers, FL
National Provider Identifier
1073551735
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4043 Issued in FL
Practice address
9617 Gulf Research LN
Fort Myers, FL 33912-4560
Phone
(239) 418-0999
NPI assigned
Jun 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4043 FL Primary

Addresses

Primary practice location

9617 Gulf Research LN
Fort Myers, FL 33912-4560

Mailing address

9617 Gulf Research LN
Fort Myers, FL 33912-4560
Phone (239) 418-0999

Other identifiers 1

IdentifierTypeStateIssuer
001974600MedicaidFL

Other names 1

  • Kimberly B Ninyo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20061213000516 FL Practitioner - Optometry 0244239580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jonathan M Frantz, MD PAGroup PAC ID 9234039140, 25 clinicians

Practice addresses (Care Compare)

12731 New Brittany Blvd
Fort Myers, FL 33907-3632
Phone (239) 418-0999

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4538MAMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan M Frantz, MD PA PastSince Feb 18, 2024 Accepting new patients
Jonathan M Frantz, MD PA Past Accepting new patients
Jonathan M Frantz, MD PA Past Accepting new patients

Organizations & group practices 4

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1073551735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9617 GULF RESEARCH LN",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124560",
            "telephone_number": "239-418-0999",
            "fax_number": "239-418-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9617 GULF RESEARCH LN",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124560",
            "telephone_number": "239-418-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDER",
        "first_name": "KIMBERLY",
        "middle_name": "B",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001974600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "NINYO",
            "middle_name": "B",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.