Kirk Justin Koogler, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

5135TG Issued in TX

Practice address

510 E Southlake Blvd Ste 100
Southlake, TX 76092-6579

Phone

(817) 481-1665

Fax

(817) 329-7613

NPI assigned

Aug 18, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

University of Houston - College of Optometry, 1995

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• KJK Eye Care LLC

  • Optometrist
  • Southlake, TX
  • NPI 1194919092
  Medicare reassignment

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1255323952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 E SOUTHLAKE BLVD STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926579",
            "telephone_number": "817-481-1665",
            "fax_number": "817-329-7613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E SOUTHLAKE BLVD STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926579",
            "telephone_number": "817-481-1665",
            "fax_number": "817-329-7613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOGLER",
        "first_name": "KIRK",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5135TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Kobeszko, M.D.
• Madhuri Latha Koganti, M.D.
• Adam Cash Kokenzie, ATC, LAT, MAT
• Emma Kolesky
• Kimberly Elaine Komon, PHD
• David E Kosmoski, MD
• Milan Kountz
• Atoosa Kourosh, MD
• Thomas Kramer, DC
• Klaudia Krauszowska

• Optometrist in Southlake, TX
• Providers in Southlake, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.