Trevor Keck, O.D.
Individual provider Active NPI Optometrist · Spencer, IN
NPI 1124437496 · NPPES record last updated Dec 31, 2014
Key facts
- NPI
- 1124437496
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 18003878A (IN)
- Practice address
- 357 W Morgan St Ste C
Spencer, IN 47460-1255 - Phone
- (812) 855-8436
- NPI assigned
- Aug 11, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Ferris State College - College of Optometry, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Myeyedr Optometry of Indiana LLC
Practice addresses (Care Compare)
357 W Morgan St C
Spencer, IN 47460-1255
Phone (812) 829-2972
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 16 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150121000680 | IN | Practitioner - Optometry | 2163746280 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18003878A | IN | MD | Optometrist |
| 4901004865 | MI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Myeyedr Optometry of Indiana, LLC | Optometrist | Current | Accepting new patients |
| Myeyedr Optometry of Indiana, LLC | Optometrist | Current |
Accepting new patients |
| Myeyedr Optometry of Indiana, LLC | Optometrist | Current |
Accepting new patients |
| Eyecare Indiana II, P.C. | Optometrist | Past | Accepting new patients |
Locations
2901 S McIntire Dr
Ste 120
Bloomington, IN 47403
Phone (812) 332-1401
1105 S College Mall Rd
Bloomington, IN 47401
Phone (812) 333-2020
2901 S McIntire Dr
Bloomington, IN 47403
Phone (812) 332-1401
9760 Lantern Rd
Fishers, IN 46037
Phone (317) 577-9200
980 Averitt Rd
Greenwood, IN 46143
Phone (317) 881-4143
804 Broad Ripple Ave
Indianapolis, IN 46220
Phone (317) 257-5421
357 W Morgan St
Ste C
Spencer, IN 47460
Phone (812) 829-1254
643 Ohio St
Terre Haute, IN 47807
Phone (812) 232-0073
8614 Westwood Center Dr
Fl 9
Vienna, VA 22182
1950 Old Gallows Rd
Ste 520
Vienna, VA 22182
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18003878A | IN | Yes |
| Optometrist | 152W00000X | 4901004865 | MI |
Addresses
Primary practice location
357 W Morgan St Ste C
Spencer, IN 47460-1255
Mailing address
9795 Crosspoint Blvd
Suite 100
Indianapolis, IN 46256-3354
Phone (317) 254-6480
Other providers in Spencer, IN
- Indiana Health Centers, Inc
- Indiana University Health Bloomington Inc
- Indiana University Health Southern Indiana Physicians, Inc
- Indiana University Health Southern Indiana Physicians, LLC
- Jennifer L. Heil, O.D., P.C.
- Kenfield Dental Group LLC
- Melissa Kenfield
- Melissa Kohlman
- Brian Krieble
- Kenin Krieger
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 31, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.