Kalen Miles Thompson, OD
Individual provider Active NPI Optometrist · Bradenton, FL
NPI 1124712948 · NPPES record last updated Oct 3, 2024
Key facts
- NPI
- 1124712948
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- OPC6244 (FL)
- Practice address
- 2003 Cortez Rd W
Bradenton, FL 34207-1241 - Phone
- (941) 756-2020
- NPI assigned
- Jun 5, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Eye Center Inc
Practice addresses (Care Compare)
2003 Cortez Rd W
Bradenton, FL 34207-1289
Phone (941) 756-2020
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- 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 |
|---|---|---|---|---|
| I20240709000406 | FL | Practitioner - Optometry | 8325583990 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPC6244 | FL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eye Center Inc | Optometrist | Current |
Accepting new patients |
| Eye Center Inc | Optometrist | Current |
Accepting new patients |
| Eye Center Inc | Optometrist | Current | Accepting new patients |
Locations
2003 Cortez Rd W
Bradenton, FL 34207
Phone (941) 756-2020
8312 US Highway 301 N
Ste 105
Parrish, FL 34219
Phone (941) 776-5770
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Optometrist | 152W00000X | OPC6244 | FL | Yes |
Addresses
Primary practice location
2003 Cortez Rd W
Bradenton, FL 34207-1241
Mailing address
2003 Cortez Rd W
Bradenton, FL 34207-1241
Phone (941) 756-2020
Other practice location 1
8312 US Highway 301 N Ste 105
Parrish, FL 34219-8725
Phone (941) 776-5770
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OPC6244 | Other | FL | PROFESSIONAL LISCENSE |
Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2024. 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.