Kyle Maxam, O.D.
Individual provider Active NPI Optometrist · Brookville, OH
NPI 1124476411 · NPPES record last updated Jul 11, 2025
Key facts
- NPI
- 1124476411
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 6478 (OH)
- Practice address
- 430 Arlington Rd Ste a
Brookville, OH 45309-1103 - Phone
- (937) 770-1265
- NPI assigned
- May 27, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- University of Missouri St Louis - School of Optometry, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Eyedocs Family Eye Care
Practice addresses (Care Compare)
430 Arlington Rd
Suite a
Brookville, OH 45309-1103
Phone (937) 770-1265
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- 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 |
|---|---|---|---|---|
| I20180220001532 | OH | Practitioner - Optometry | 3072874890 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6478 | OH | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eyedocs Family Eye Care | Optometrist | Current |
Accepting new patients |
Locations
430 Arlington Rd
Brookville, OH 45309
Phone (937) 770-1114
430 Arlington Rd
Ste B
Brookville, OH 45309
Phone (937) 770-1265
430 Arlington Rd
Ste A
Brookville, OH 45309
Phone (937) 770-1265
1265 W Market St
Germantown, OH 45327
Phone (937) 770-1265
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 6478 | OH | Yes |
Addresses
Primary practice location
430 Arlington Rd Ste a
Brookville, OH 45309-1103
Mailing address
430 Arlington Rd
Brookville, OH 45309-1103
Phone (937) 770-1265
Other providers in Brookville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2025. 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.