Individual provider Active NPI

Brian Edward Kurtz, O.D.

  • Optometrist
  • Enterprise, AL
National Provider Identifier
1245228592
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
R133TA477 Issued in AL
Practice address
820 E Lee St
Enterprise, AL 36330-2011
Phone
(334) 393-2020
NPI assigned
Oct 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT-001821 GA
Optometrist 152W00000X R133TA477 AL Primary

Addresses

Primary practice location

820 E Lee St
Enterprise, AL 36330-2011

Mailing address

PO Box 207243
Dallas, TX 75320-7243
Phone (636) 200-4393

Other practice location 1

3801 Northside Dr
Macon, GA 31210
Phone (478) 475-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130429000504 GA Practitioner - Optometry 5496876161 Reassigns benefits to 1 organization
I20220523000962 AL Practitioner - Optometry 5496876161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyecare Associates, Inc.Group PAC ID 0749254001, 52 clinicians

Practice addresses (Care Compare)

820 E Lee St
Enterprise, AL 36330-2011
Phone (334) 393-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R133TA477ALMDOptometrist
OPT-001821GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Oct 16, 2018 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Oct 16, 2018 Accepting new patients
Eyecare Associates, Inc. Optometrist Current Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Current Accepting new patients
Eyecare Associates, Inc. Optometrist CurrentSince Mar 17, 2022 Accepting new patients
Eyecare Associates, Inc. Optometrist CurrentSince Mar 17, 2022 Accepting new patients
Eyecare Associates, Inc. Past Accepting new patients

Locations

820 E Lee St
Enterprise, AL 36330
Phone (334) 393-2020

7880 Old Madison Pike
Madison, AL 35758
Phone (256) 772-8711

606 S George Wallace Dr
Troy, AL 36081
Phone (334) 566-2020

4875 Altama Ave
Brunswick, GA 31520
Phone (912) 554-0010

3801 Northside Dr
Macon, GA 31210
Phone (478) 475-1600

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ecp_eca

Organizations & group practices 7

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": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1245228592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207243",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753207243",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E LEE ST",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302011",
            "telephone_number": "334-393-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3801 Northside Dr",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "31210",
            "country_code": "US",
            "telephone_number": "478-475-1600",
            "fax_number": "478-475-1876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KURTZ",
        "first_name": "BRIAN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT-001821",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "R133TA477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, AL

Sources for this page

Verify at the official NPI Registry.