Individual provider Active NPI

Ben Leonard

  • Optometrist
  • Calvert City, KY
National Provider Identifier
1306191218
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1896DT Issued in KY
Practice address
43 Industrial Pkwy
Calvert City, KY 42029-8416
Phone
(270) 395-8331
NPI assigned
Jul 17, 2012
Last updated
Oct 15, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1896DT KY Primary
Specialist 174400000X 1896DT KY

Addresses

Primary practice location

43 Industrial Pkwy
Calvert City, KY 42029-8416

Mailing address

43 Industrial Pkwy
Calvert City, KY 42029-8416
Phone (270) 395-8331

Other identifiers 2

IdentifierTypeStateIssuer
7100215320MedicaidKY
000000781207OtherKYANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20120920000359 KY Practitioner - Optometry 2769630565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarkson Optometry Midwest IncGroup PAC ID 0749504165, 78 clinicians

Practice addresses (Care Compare)

43 Industrial Pkwy
Calvert City, KY 42029-8416
Phone (270) 395-8331

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1896DTKYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Clarkson Optometry Midwest Inc Optometrist Current Accepting new patients
Clarkson Optometry Midwest Inc Optometrist CurrentSince Jan 8, 2017 Accepting new patients
Clarkson Optometry Midwest Inc Optometrist CurrentSince Jan 8, 2017 Accepting new patients
20-20 Eyecare PSC Optometrist Past Accepting new patients

Locations

109 W 5th St
Benton, KY 42025
Phone (270) 527-7421

43 Industrial Pkwy
Calvert City, KY 42029
Phone (270) 395-8331

3978 Alexandria Pike
Cold Spring, KY 41076
Phone (859) 441-8500

1400 Commonwealth Dr
Mayfield, KY 42066
Phone (270) 247-2417

817 N 12th St
Murray, KY 42071
Phone (270) 753-2842

1748 Broadway St
Paducah, KY 42001
Phone (270) 443-9955

Interoperability endpoints

  • Direct secure messaging: bleonard@direct.eyecare-partners.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1306191218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 INDUSTRIAL PKWY",
            "city": "CALVERT CITY",
            "state": "KY",
            "postal_code": "420298416",
            "telephone_number": "270-395-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 INDUSTRIAL PKWY",
            "city": "CALVERT CITY",
            "state": "KY",
            "postal_code": "420298416",
            "telephone_number": "270-395-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "BEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-17",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1896DT",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "KY",
            "license": "1896DT",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100215320",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000781207",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Calvert City, KY

Sources for this page

Verify at the official NPI Registry.