Kayla N Black, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

18003899A Issued in IN

Practice address

4424 S 7TH St
Terre Haute, IN 47802-4304

Phone

(812) 299-3937

Fax

(812) 299-8670

NPI assigned

Jun 11, 2015

Sex

Female

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 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

Specialty

Optometry

Education

Indiana University - School of Optometry, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dr Blacks Optometry PCGroup PAC ID 5991806333, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr Blacks Optometry PC

  • Optometrist
  • Terre Haute, IN
  • NPI 1194925222
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1326429713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4424 S 7TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024304",
            "telephone_number": "812-299-3937",
            "fax_number": "812-299-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4424 S 7TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024304",
            "telephone_number": "812-299-3937",
            "fax_number": "812-299-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "KAYLA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003899A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Bishop, P.T.
• Leslie Bissell, PHD, HSPP
• George B Bittar, MD
• Sean Kevin Bitz, CRNA
• Brianna Black, RBT
• Steven G Black, OD
• Kenzie Blackburn
• Tanna K Blackburn, MA, BCBA
• Alec Blair
• Scott Patrick Blake

• Optometrist in Terre Haute, IN
• Providers in Terre Haute, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; 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.