Individual provider Active NPI

Kylene Ann Polhamus, O.D.

  • Optometrist
  • Carmel, IN
National Provider Identifier
1427464890
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003841A Issued in IN
Practice address
1320 City Center Dr Ste 150
Carmel, IN 46032-3104
Phone
(574) 293-3545
NPI assigned
Jul 7, 2014
Last updated
Dec 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18003841A IN Primary

Addresses

Primary practice location

1320 City Center Dr Ste 150
Carmel, IN 46032-3104

Mailing address

1320 City Center Dr Ste 150
Carmel, IN 46032-3104
Phone (317) 846-4223

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20140926002007 IN Practitioner - Optometry 7810117728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indianapolis Ophthalmology PCGroup PAC ID 9335190354, 7 clinicians

Practice addresses (Care Compare)

11455 N Meridian St
Suite 100
Carmel, IN 46032-1679
Phone (317) 846-4223

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18003841AINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Indianapolis Ophthalmology PC CurrentSince Oct 1, 2022 Accepting new patients
Indianapolis Ophthalmology PC CurrentSince Oct 1, 2022 Accepting new patients

Locations

11455 N Meridian St
Ste 100
Carmel, IN 46032
Phone (317) 819-0742

1320 City Center Dr
Ste 150
Carmel, IN 46032
Phone (317) 846-4223

3850 Shore Dr
Ste 100
Indianapolis, IN 46254
Phone (317) 293-1420

Interoperability endpoints

  • Direct secure messaging: kylene.polhamus.p1@direct.abramseyecare.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1427464890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 CITY CENTER DR STE 150",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323104",
            "telephone_number": "317-846-4223",
            "fax_number": "317-846-6063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 CITY CENTER DR STE 150",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323104",
            "telephone_number": "574-293-3545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLHAMUS",
        "first_name": "KYLENE",
        "middle_name": "ANN",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-07",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003841A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.