Individual provider Active NPI

Kent Alan Kirk, M.D.

  • Ophthalmology Physician
  • River Forest, IL
National Provider Identifier
1154340941
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036070489 Issued in IL
Practice address
7427 Lake St
River Forest, IL 60305-1817
Phone
(708) 771-3334
Fax
(708) 771-9614
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 036070489 IL Primary

Addresses

Primary practice location

7427 Lake St
River Forest, IL 60305-1817

Mailing address

7427 Lake St
River Forest, IL 60305-1817
Phone (708) 771-3334

Other identifiers 3

IdentifierTypeStateIssuer
1607956OtherILBC/BS ILLINOIS
362658561OtherILFED TAX ID #
36070489MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101115001121 IL Practitioner - Ophthalmology 2769382969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Northwestern University Feinberg Medical School, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kirk Eye Center SCGroup PAC ID 2769527118, 8 clinicians

Practice addresses (Care Compare)

7427 Lake St
River Forest, IL 60305-1817
Phone (708) 771-3334

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery316

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Williams Eye Institute, PC Ophthalmology CurrentSince Feb 1, 2014 Accepting new patients
Kirk Eye Center, SC Ophthalmology CurrentSince Apr 1, 2001 Accepting new patients
River Forest Surgery Center LLC Current Accepting new patients
Williams Eye Institute, PC Ophthalmology CurrentSince Feb 1, 2014 Accepting new patients
River Forest Surgery Center LLC Current Accepting new patients
Novamed Surgery Center of Bedford, LLC PastSince Apr 1, 2004 Accepting new patients

Locations

45 S Park Blvd
Ste 375
Glen Ellyn, IL 60137
Phone (630) 858-4660

7427 Lake St
River Forest, IL 60305
Phone (708) 488-1200

9797 Massachusetts St
Crown Point, IN 46307
Phone (219) 649-2704

6850 Hohman Ave
Hammond, IN 46324
Phone (219) 931-7509

540 Hospital Dr
Winamac, IN 46996
Phone (574) 935-4327

Organizations & group practices 6

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1154340941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7427 LAKE ST",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051817",
            "telephone_number": "708-771-3334",
            "fax_number": "708-771-9614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7427 LAKE ST",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051817",
            "telephone_number": "708-771-3334",
            "fax_number": "708-771-9614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "KENT",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036070489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS ILLINOIS",
            "identifier": "1607956",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FED TAX ID #",
            "identifier": "362658561",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36070489",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in River Forest, IL

Sources for this page

Verify at the official NPI Registry.