Individual provider Active NPI

Ahmad Michael Morshedi, O.D.

  • Optometrist
  • Louisville, KY
National Provider Identifier
1114200847
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
KY2047DT Issued in KY
Practice address
2020 Bashford Manor Lane
Louisville, KY 40218
Phone
(502) 716-2020
Fax
(502) 451-6884
NPI assigned
Sep 20, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA2226 MD
Optometrist 152W00000X KY2047DT KY Primary

Addresses

Primary practice location

2020 Bashford Manor Lane
Louisville, KY 40218

Mailing address

2020 Bashford Manor LN
Louisville, KY 40218-2114
Phone (502) 716-2020

Other practice location 1

3408 Bardstown Rd
Louisville, KY 40218-4608
Phone (502) 912-9884

Other practice location 2

2020 Bashford Manor Ln
Louisville, KY 40218
Phone (502) 716-2020

Other identifiers 1

IdentifierTypeStateIssuer
1679016893MedicaidKY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170106000999 KY Practitioner - Optometry 6204071665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2020 Bashford Manor LN
Louisville, KY 40218-2114
Phone (502) 716-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
KY2047DTKYMDOptometrist
TA2226MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel Poth, O.D. and Associates, P.C. Optometrist CurrentSince Feb 23, 2013 Accepting new patients
Daniel Poth, O.D. and Associates, P.C. Optometrist PastSince Feb 23, 2013 Accepting new patients
Metro Eyes Vision Care PLLC Optometrist Past Accepting new patients

Locations

4627 Duke St Ste 508
Ste 508
Alexandria, VA 22304
Phone (703) 823-6611

11130L South Lakes Dr
Reston, VA 20191
Phone (703) 471-1012

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": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1114200847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 BASHFORD MANOR LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402182114",
            "telephone_number": "502-716-2020",
            "fax_number": "502-451-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 BASHFORD MANOR LANE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40218",
            "telephone_number": "502-716-2020",
            "fax_number": "502-451-6884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3408 Bardstown Rd",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402184608",
            "country_code": "US",
            "telephone_number": "502-912-9884",
            "fax_number": "502-912-9885",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2020 Bashford Manor Ln",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "40218",
            "country_code": "US",
            "telephone_number": "502-716-2020",
            "fax_number": "502-451-6882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORSHEDI",
        "first_name": "AHMAD",
        "middle_name": "MICHAEL",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-20",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2226",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "KY2047DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679016893",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.