Individual provider Active NPI

Kiersten Hopkins, OD

  • Optometrist
  • Indianapolis, IN
National Provider Identifier
1083346910
Registry record updated Mar 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004466A Issued in IN
Practice address
1481 W 10TH St
Indianapolis, IN 46202-2803
Phone
(317) 554-0000
NPI assigned
Jun 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ATI-4641 OR
Optometrist 152W00000X 18004466A IN Primary

Addresses

Primary practice location

1481 W 10TH St
Indianapolis, IN 46202-2803

Mailing address

1481 W 10TH St
Indianapolis, IN 46202-2803
Phone (317) 554-0000

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
I20250205001127 IN Practitioner - Optometry 8729518865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Ophthalmology P CGroup PAC ID 4688611692, 10 clinicians

Practice addresses (Care Compare)

3301 Lake Ave
Fort Wayne, IN 46805-5529
Phone (260) 422-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18004466AINMDOptometrist
ATI-4641ORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Ophthalmology P C Optometrist CurrentSince Feb 1, 2025 Accepting new patients
Northeast Ophthalmology P C CurrentSince Feb 1, 2025 Accepting new patients
Northeast Indiana Ambulatory Surgery Center LLC Past Accepting new patients

Locations

11277 Twin Creeks Dr
Ste A
Fort Wayne, IN 46845

11277 Twin Creeks Dr
Fort Wayne, IN 46845
Phone (260) 422-3937

3301 Lake Ave
Fort Wayne, IN 46805
Phone (219) 422-3939

7750 W Jefferson Blvd
Ste B
Fort Wayne, IN 46804
Phone (260) 459-9595

Interoperability endpoints

  • Direct secure messaging: khopkins@vco.intellechartdirect.net

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": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710028800000",
    "number": "1083346910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1481 W 10TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022803",
            "telephone_number": "317-554-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1481 W 10TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022803",
            "telephone_number": "317-554-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOPKINS",
        "first_name": "KIERSTEN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2024-03-10",
        "certification_date": "2024-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "ATI-4641",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004466A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.