Individual provider Active NPI

Kaitlyn Marie Luchansky, O.D.

  • Optometrist
  • Boardman, OH
National Provider Identifier
1255871109
Registry record updated Jun 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6560 Issued in OH
Practice address
8135 Market St
Boardman, OH 44512
Phone
(330) 758-0900
NPI assigned
Feb 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 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 6560 OH Primary

Addresses

Primary practice location

8135 Market St
Boardman, OH 44512

Mailing address

8135 Market St
Youngstown, OH 44512-6244
Phone (330) 758-0900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, WV2 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
I20170720003186 OH Practitioner - Optometry 2466722681 Reassigns benefits to 2 organizations
I20191107002010 WV Practitioner - Optometry 2466722681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Eye Center, IncGroup PAC ID 2062480429, 9 clinicians

Practice addresses (Care Compare)

21375 Lorain Rd
Fairview Park, OH 44126-2122
Phone 4403333097313

Merit-based Incentive Payment System (MIPS)

Final score
82.04 of 100Reported as group
Quality
95.11
Improvement activities
40
Cost
46.64

Merit-based Incentive Payment System (MIPS)

Final score
82.62 of 100Reported as group
Quality
80.75
Promoting interoperability
78
Improvement activities
40
Cost
79.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6560OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Eye Center, Inc CurrentSince Aug 1, 2023 Accepting new patients
Fairview Eye Center, Inc Optometrist CurrentSince Aug 1, 2023 Accepting new patients
Fairview Eye Center, Inc. Optometrist Past Accepting new patients
Robert L Stein DO PC PastSince Sep 24, 2021 Accepting new patients
Fairview Eye Center Past Accepting new patients

Locations

21375 Lorain Rd
Fairview Park, OH 44126
Phone (440) 333-3060

7003 Pearl Rd
Ste 200
Middleburg Heights, OH 44130
Phone (216) 888-2333

7003 Pearl Rd
Middleburg Heights, OH 44130
Phone (440) 888-2333

Interoperability endpoints

  • Direct secure messaging: kluchansky@fairvieweyecenter.imwdirect.com

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": "1488067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1255871109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8135 MARKET ST",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445126244",
            "telephone_number": "330-758-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8135 MARKET ST",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "44512",
            "telephone_number": "330-758-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCHANSKY",
        "first_name": "KAITLYN",
        "middle_name": "MARIE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-26",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.