Individual provider Active NPI

Brad A Kimball, O.D.

  • Optometrist
  • Billings, MT
National Provider Identifier
1174691109
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
MT665 Issued in MT
Practice address
430 Lake Elmo Dr
Billings, MT 59105-3037
Phone
(406) 252-9927
Fax
(406) 252-6567
NPI assigned
Nov 30, 2006
Last updated
Oct 30, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X MT665 MT Primary

Addresses

Primary practice location

430 Lake Elmo Dr
Billings, MT 59105-3037

Mailing address

430 Lake Elmo Dr
Billings, MT 59105-3066
Phone (406) 252-9927

Other identifiers 2

IdentifierTypeStateIssuer
P00180029OtherMTRAILROAD MEDICARE
480607MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20041026000605 MT Practitioner - Optometry 3971563560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heights Eyecare, Inc.Group PAC ID 7810957495, 6 clinicians

Practice addresses (Care Compare)

430 Lake Elmo Dr
Billings, MT 59105-3037
Phone (406) 252-9927

Merit-based Incentive Payment System (MIPS)

Final score
71.81 of 100Reported as individual
Quality
43.61
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MT665MTMDOptometrist
665MTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Heights Eyecare, Inc. Optometrist CurrentSince Oct 1, 2004 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

430 Lake Elmo Dr
Billings, MT 59105
Phone (406) 252-9927

430 Lake Elmo Dr
#1
Billings, MT 59105
Phone (406) 252-9927

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1174691109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 LAKE ELMO DR",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591053066",
            "telephone_number": "406-252-9927",
            "fax_number": "406-252-6567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 LAKE ELMO DR",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591053037",
            "telephone_number": "406-252-9927",
            "fax_number": "406-252-6567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "BRAD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "MT665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00180029",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "480607",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

Verify at the official NPI Registry.