Individual provider Active NPI

Rodney B. Kusumi, M.D.

  • Ophthalmology Physician
  • Lafayette, IN
National Provider Identifier
1265458160
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
01057576A Issued in IN
Practice address
1013 N 13TH St
Lafayette, IN 47904-2011
Phone
(765) 428-8888
Fax
(765) 428-8889
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 01057576A IN Primary

Addresses

Primary practice location

1013 N 13TH St
Lafayette, IN 47904-2011

Mailing address

1013 N 13TH St
Lafayette, IN 47904-2011
Phone (765) 428-8888

Other identifiers 3

IdentifierTypeStateIssuer
000000341839OtherINANTHEM BLUE CROSS/BLUE SH
200441070MedicaidIN
P00176469OtherINRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040910000720 IN Practitioner - Ophthalmology 4880661842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1013 N 13TH St
Lafayette, IN 47904-2011
Phone (765) 428-8888

Hospital & facility affiliations

  • Indiana University Health Arnett Hospital Hospital, Lafayette, IN, CCN 150173

Merit-based Incentive Payment System (MIPS)

Final score
8.73 of 100Reported as individual
Quality
15
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01057576AINMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Eye Care Inc. Ophthalmology Past Accepting new patients
Gibson Community Hospital Association Ophthalmology Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1265458160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 N 13TH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042011",
            "telephone_number": "765-428-8888",
            "fax_number": "765-428-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 N 13TH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042011",
            "telephone_number": "765-428-8888",
            "fax_number": "765-428-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSUMI",
        "first_name": "RODNEY",
        "middle_name": "B.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "01057576A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS/BLUE SH",
            "identifier": "000000341839",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200441070",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00176469",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.