Individual provider Active NPI

Andrew McKay Burkhart, O.D.

  • Optometrist
  • Kokomo, IN
National Provider Identifier
1326106733
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002874 Issued in IN
Practice address
511 W Lincoln Rd
Kokomo, IN 46902-3481
Phone
(765) 453-2907
Fax
(765) 453-6111
NPI assigned
Dec 5, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002874 IN Primary

Addresses

Primary practice location

511 W Lincoln Rd
Kokomo, IN 46902-3481

Mailing address

511 W Lincoln Rd
Kokomo, IN 46902-3481
Phone (765) 453-2907

Other identifiers 1

IdentifierTypeStateIssuer
200177240-BMedicaidIN

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120125000702 IN Practitioner - Optometry 1850591371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Indiana Professional PCGroup PAC ID 2365826179, 30 clinicians

Practice addresses (Care Compare)

2315 W Jefferson St
Preferred Eye Care Kokomo
Kokomo, IN 46901-4119
Phone (765) 455-0404

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002874INMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
DRS Borish Burkhart & Reid Inc Optometrist CurrentSince Dec 7, 2009 Accepting new patients
Aeg Indiana Professional PC Optometrist CurrentSince Sep 7, 2022 Accepting new patients
Dr Tabitha G Temple PC Optometrist PastSince Jul 16, 2007 Accepting new patients

Locations

2315 W Jefferson St
Kokomo, IN 46901
Phone (765) 342-3686

511 W Lincoln Rd
Kokomo, IN 46902
Phone (317) 453-2907

711 N River Dr
Marion, IN 46952
Phone (765) 662-6565

2250 N Pointe Dr
Warsaw, IN 46582
Phone (574) 267-3515

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, 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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1326106733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 W LINCOLN RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023481",
            "telephone_number": "765-453-2907",
            "fax_number": "765-453-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 W LINCOLN RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023481",
            "telephone_number": "765-453-2907",
            "fax_number": "765-453-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHART",
        "first_name": "ANDREW",
        "middle_name": "MCKAY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200177240-B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.