Paul Timothy Bertram, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1569DT Issued in KY

Practice address

989 Governors LN
Lexington, KY 40513-1173

Phone

(859) 554-8265

Fax

(859) 277-4490

NPI assigned

Apr 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Simpson Optical PLLCGroup PAC ID 6406847029, 10 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Simpson Optical PLLC

  • Optometrist
  • Lexington, KY
  • NPI 1780875880
  Medicare reassignment Care Compare group NPD
• Dr Shewmaker & Associates Optometrists Inc

  • Optometrist
  • Dry Ridge, KY
  • NPI 1801949227
  NPD (past)
• Dr Shewmaker & Associates Optometrists Inc

  • Optometrist
  • Fort Mitchell, KY
  • NPI 1871641332
  NPD (past)
• Kiosk Medicine Kentucky LLC

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1205885035
  NPD (past)

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1093770570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "989 GOVERNORS LN",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131173",
            "telephone_number": "859-554-8265",
            "fax_number": "859-277-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "989 GOVERNORS LN",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131173",
            "telephone_number": "859-554-8265",
            "fax_number": "859-277-4490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4101 Tates Creek Centre Dr",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405173066",
            "country_code": "US",
            "telephone_number": "859-245-3332",
            "fax_number": "859-277-4490",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "340 Meijer Way",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405033340",
            "country_code": "US",
            "telephone_number": "859-278-2020",
            "fax_number": "859-277-4490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERTRAM",
        "first_name": "PAUL",
        "middle_name": "TIMOTHY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1569DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77000974",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Regina Marie Berry, PH.D
• Elizangela Bertoli, D.D.S.
• Benjamin Bertram, PA-C
• Jessica Lynn Bertram, MD
• Leslee A Bertram, APRN
• Sharon M Bertram, RPH
• Lauren Vincent Besednjak, BSN, RN, SANE
• Deidra Dawn Beshear, MD
• Ivo O Besong Mangeb, MD
• Coby Leigh Bessinger

• Optometrist in Lexington, KY
• Providers in Lexington, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; 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.