Kimberly Couture Ireland, M.D.

Individual provider Active NPI Ophthalmology Physician · Summit, WI

NPI 1366435851 · NPPES record last updated Mar 26, 2013

Key facts

NPI
1366435851
Entity type
Individual (NPI type 1)
Primary specialty
Ophthalmology Physician 207W00000X
License
42556 (WI)
Practice address
36500 Aurora Dr
Summit, WI 53066-4899
Phone
(262) 434-5000
Fax
(262) 434-5000
NPI assigned
Aug 30, 2005
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Ophthalmology
Education
Albany Medical College of Union University, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes at the Villages PA (16 clinicians)

Practice addresses (Care Compare)

1050 Old Camp Rd
Suite 230
The Villages, FL 32162-1762
Phone (352) 350-8484

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100 (group)

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1966

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20121204000037 FL Practitioner - Ophthalmology 5395883300 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
42556WIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St . Lukes at the Villages, PA Ophthalmology Current
since Nov 19, 2012
Accepting new patients
Coren Eye Group PLLC Past Accepting new patients
St. Lukes Surgical at the Villages, Inc Past Accepting new patients

Locations

43309 US Highway 19 N
Tarpon Springs, FL 34689
Phone (727) 938-2020

2955 Brownwood Blvd
Ste 303
The Villages, FL 32163
Phone (352) 350-8484

1050 Old Camp Rd
Ste 230
The Villages, FL 32162
Phone (352) 350-8484

1050 Old Camp Rd
The Villages, FL 32162
Phone (352) 606-4708

Interoperability endpoints

  • Direct secure messaging: kireland563593@direct.shands.ufl.edu
  • Direct secure messaging: kimberly.irelandmd.p3@direct.stlukeseye.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 42556 WI Yes

Addresses

Primary practice location

36500 Aurora Dr
Summit, WI 53066-4899

Mailing address

1050 Old Camp Rd
Building # 230
The Villages, FL 32162-1762
Phone (352) 350-8484

Other identifiers

IdentifierTypeStateIssuer
7075205OtherWIAETNA
34017100MedicaidWI
8808855OtherWICIGNA

Other providers in Summit, WI

All providers in Summit, WI · Ophthalmology Physician in Wisconsin

Sources for this page

Verify at the official NPI Registry.