Karen T Fortman, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4599 Issued in OH

Practice address

1086 Fairington Dr
Sidney, OH 45365-8913

Phone

(937) 492-9197

Fax

(937) 492-1901

NPI assigned

Apr 5, 2006

Last updated

Nov 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Optometry

Education

Ohio State University - College of Optometry, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primary Eyecare Associates IncGroup PAC ID 2062496284, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

21.29 of 100Reported as individual

Quality

42.59

Improvement activities

0

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kfortman@directaddress.net

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.

• Primary Eyecare Associates Inc

  • Optometrist
  • Sidney, OH
  • NPI 1093927881
  Medicare reassignment Care Compare group NPD
• Primary Eyecare Associates Inc

  • Optometrist
  • Fort Loramie, OH
  • NPI 1528270311
  NPD

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1205898145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 FAIRINGTON DR",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453658913",
            "telephone_number": "937-492-9197",
            "fax_number": "937-492-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1086 FAIRINGTON DR",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453658913",
            "telephone_number": "937-492-9197",
            "fax_number": "937-492-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTMAN",
        "first_name": "KAREN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0176440001",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0176440002",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0991431",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fly Family Health LLC
• Haley Fogt
• Jolene Fogt
• Michael Fogt
• Foot and Ankle Centers of Ohio, Inc.
• Melanie Francis
• Juanita Louise Frank
• Jennie Freeman
• Melissa Freistuhler
• Fresenius Medical Care Sidney, LLC (Renal Care Group Sidney)

• Optometrist in Sidney, OH
• Providers in Sidney, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.