Kiersten Wytovak

Primary specialty

OptometristTaxonomy code 152W00000X

License

18004297A Issued in IN

Practice address

1511 N Post Rd Ste a
Indianapolis, IN 46219-4248

Phone

(317) 899-1017

NPI assigned

Jul 28, 2021

Sex

Female

Sole proprietor

No

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

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

First Impressions Optometric Associates, LLCGroup PAC ID 6800281825, 30 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• First Impressions Optometric Associates, LLC

  • Optometrist
  • Bloomington, IN
  • NPI 1083366363
  Medicare reassignment Care Compare group NPD
• Family First Vision Care Kentucky, LLC

  • Optometrist
  • Fort Mitchell, KY
  • NPI 1396396750

  IN

  Medicare reassignment NPD
• Family First Vision Care Indiana LLC

  • Optometrist
  • Mishawaka, IN
  • NPI 1922525427
  Medicare reassignment
• First Impressions Optometric Associates, LLC

  • Eyewear Supplier
  • Highland, IN
  • NPI 1942960539

  Optometrist

  NPD

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1386317006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 HARTMETZ AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477125003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 N POST RD STE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194248",
            "telephone_number": "317-899-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYTOVAK",
        "first_name": "KIERSTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004297A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Wysocki, MD, PHD
• Grant Wysong
• Alison Marie Wyss, AU.D., CCC-A
• Holly P Wyss, RN, CS, FNP-C
• Rachel S Wyss, MD
• Xceptional Home Care Services LLC
• Xclusive Home Services LLC
• Denisa Xhani, MD
• Ann Daphne XI, PHARMD, RPH
• Adam Yao Xiao, MD, PHD

• Optometrist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.