Mary Elizabeth Graham
Individual provider Active NPI Optometrist · Louisville, KY
NPI 1356030993 · NPPES record last updated Jan 16, 2025
Key facts
- NPI
- 1356030993
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2349DT (KY)
- Practice address
- 6828 Bardstown Rd
Louisville, KY 40291-3050 - Phone
- (502) 231-2020
- NPI assigned
- May 1, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Clarkson Optometry Midwest Inc
Practice addresses (Care Compare)
6828 Bardstown Rd
Louisville, KY 40291-3050
Phone (502) 231-2020
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230824003738 | KY | Practitioner - Optometry | 4587027487 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2349DT | KY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clarkson Optometry Midwest Inc | Optometrist | Current |
Accepting new patients |
| Clarkson Optometry Midwest Inc | Optometrist | Current |
Accepting new patients |
| Clarkson Optometry Midwest Inc | Optometrist | Current | Accepting new patients |
| 20-20 Eyecare PSC | Optometrist | Past | Accepting new patients |
Locations
3978 Alexandria Pike
Cold Spring, KY 41076
Phone (859) 441-8500
10639 Dixie Hwy
Louisville, KY 40272
Phone (502) 231-2020
6828 Bardstown Rd
Louisville, KY 40291
Phone (502) 231-2020
10232 Westport Rd
Louisville, KY 40241
Phone (502) 339-2042
544 Conestoga Pkwy
Ste 17
Shepherdsville, KY 40165
Phone (502) 955-2020
Interoperability endpoints
- mollyholder@direct.eyecare-partners.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Optometrist | 152W00000X | 2349DT | KY | Yes |
Addresses
Primary practice location
6828 Bardstown Rd
Louisville, KY 40291-3050
Mailing address
PO Box 207170
Dallas, TX 75320-7170
Phone (636) 200-4393
Other practice location 1
10639 Dixie Hwy
Louisville, KY 40272-4349
Phone (502) 933-9200
Other practice location 2
10232 Westport Rd
Louisville, KY 40241-2148
Phone (502) 339-2042
Other practice location 3
544 Conestoga Pkwy Ste 17
Shepherdsville, KY 40165-5677
Phone (502) 955-2020
Other names
- Mary Elizabeth Holder
Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.