Individual provider Active NPI

Kylie Sebastian, OD

  • Optometrist
  • Kokomo, IN
National Provider Identifier
1114376365
Registry record updated Dec 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003966 Issued in IN
Practice address
1601 W Lincoln Rd
Kokomo, IN 46902-3275
Phone
(765) 453-5696
Fax
(765) 455-4323
NPI assigned
Jun 8, 2016
Last updated
Dec 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18003966 IN Primary

Addresses

Primary practice location

1601 W Lincoln Rd
Kokomo, IN 46902-3275

Mailing address

PO Box 549
Wabash, IN 46992-0549
Phone (260) 569-9550

Other identifiers 2

IdentifierTypeStateIssuer
P01707911OtherINRAILROAD MEDICARE
201364070MedicaidIN

Other names 1

  • Kylie Cardwell Former name

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
I20160615000223 IN Practitioner - Optometry 8921399312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Eye Consultants PCGroup PAC ID 2961399217, 71 clinicians

Practice addresses (Care Compare)

1601 W Lincoln Rd
Kokomo, IN 46902-3275
Phone (765) 453-5696

2750 Central Ave
Columbus, IN 47201-3125
Phone (812) 372-4463

301 J St
La Porte, IN 46350-4734
Phone (219) 362-8923

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
55.99 of 100Reported as group
Quality
31.67
Improvement activities
40
Cost
78.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18003966INMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Eye Consultants, P.C. Optometrist CurrentSince Aug 8, 2016 Accepting new patients
Midwest Eye Consultants, P.C. Current Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients

Locations

1601 W Lincoln Rd
Kokomo, IN 46902
Phone (765) 453-5696

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512604800000",
    "number": "1114376365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469920549",
            "telephone_number": "260-569-9550",
            "fax_number": "260-569-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 W LINCOLN RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023275",
            "telephone_number": "765-453-5696",
            "fax_number": "765-455-4323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEBASTIAN",
        "first_name": "KYLIE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-08",
        "last_updated": "2017-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01707911",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201364070",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLIE",
            "last_name": "CARDWELL",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.