Courtney Nicole Kassenbrock, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

18003843 Issued in IN

Practice address

54 Monument Cir
Ste 125
Indianapolis, IN 46204-2942

Phone

(317) 631-1200

Fax

(317) 631-1600

NPI assigned

Jul 8, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Indiana University - School of Optometry, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

City Optical Co IncGroup PAC ID 5597668574, 49 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• City Optical Co., Inc.

  dba Dr Tavel Family Eye Care

  • Optometrist
  • Bloomington, IN
  • NPI 1003805185
  Medicare reassignment Care Compare group NPD
• City Optical Co., Inc.

  dba Dr. Tavel Family Eye Care

  • Optometrist
  • Merrillville, IN
  • NPI 1356233068
  NPD
• City Optical Co., Inc.

  dba Dr Tavel Family Eye Care

  • Optometrist
  • Lebanon, IN
  • NPI 1568791697
  NPD
• City Optical Co., Inc.

  • Optometrist
  • Fishers, IN
  • NPI 1366274235
  NPD (past)
• Eyecare Indiana II, P.C.

  dba C&B Optical One

  • Optometrist
  • Indianapolis, IN
  • NPI 1407134950
  NPD (past)

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1093121303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9795 CROSSPOINT BLVD",
            "address_2": "STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462563354",
            "telephone_number": "317-254-6480",
            "fax_number": "317-259-8609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 MONUMENT CIR",
            "address_2": "STE 125",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462042942",
            "telephone_number": "317-631-1200",
            "fax_number": "317-631-1600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 S Raceway Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462311415",
            "country_code": "US",
            "telephone_number": "317-273-8474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASSENBROCK",
        "first_name": "COURTNEY",
        "middle_name": "NICOLE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohsina Kashif, M.D.
• Kelly M Kasper, MD
• Mackenzie Kasper
• Areef Kassam, M.D.
• Nawal M Kassem, MD
• Erin Kassing
• Alaa Kassir, MD, MSCBI
• George Sami Kassis, MD
• Kaitlyn Kastberg, PHARMD
• Nicole Kastner, PT, DPT

• Optometrist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.