Vivian M Kloke, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046008375 Issued in IL

Practice address

735 Insight Ave
O Fallon, IL 62269-2193

Phone

(618) 628-2903

Fax

(618) 628-2913

NPI assigned

Aug 27, 2006

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

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in IL

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

University of Missouri St Louis - School of Optometry, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Eye Care of Ofallon PCGroup PAC ID 6204926843, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.18 of 100Reported as group

Quality

66.35

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vivian.kloke@direct.revolutionehr.com
• FHIR API: https://fhir4.healow.com/fhir/r4/FIBADD

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.

• Family Eye Care of Ofallon PC

  • Optometrist
  • O Fallon, IL
  • NPI 1801926340
  Medicare reassignment Care Compare group NPD
• Associated Foot Surgeons of Southwest Illinois, LTD.

  • Foot & Ankle Surgery Podiatrist
  • Belleville, IL
  • NPI 1740653591
  NPD (past)
• Curators of the University of Missouri

  • Community/Retail Pharmacy
  • Jefferson City, MO
  • NPI 1740083641
  NPD (past)

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1346358645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 INSIGHT AVE",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692193",
            "telephone_number": "618-628-2903",
            "fax_number": "618-628-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 INSIGHT AVE",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692193",
            "telephone_number": "618-628-2903",
            "fax_number": "618-628-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOKE",
        "first_name": "VIVIAN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-27",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2202035",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TIN FOR OFFICE",
            "identifier": "1801926340",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "259903",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "08206037",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008375",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH PLAN",
            "identifier": "400662",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danika Ann Kingsley, PHARM.D
• Mary Mayuulu Kinkelaar, RBT
• Dannette Kinsella
• Kirk D. Satrom, DDS Ms PC
• Tracie Kloeppel, CRNA
• Megan Samantha Knetzer, FNP
• Richard Gerhard Knight, MSN FNP-BC
• Kelsey Elyse Koenig, PA-C
• Miranda Koesterer, OTR/L
• Haley Marie Kohnen, PTA

• Optometrist in O Fallon, IL
• Providers in O Fallon, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.