Individual provider Active NPI

Kurt K Lark, M.D.

  • Ophthalmology Physician
  • Concord, NC
National Provider Identifier
1497748396
Registry record updated May 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
200000505 Issued in NC
Practice address
201 Lephillip Court N.E.
Concord, NC 28025
Phone
(704) 782-1127
Fax
(704) 782-1207
NPI assigned
Aug 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 200000505 NC Primary

Addresses

Primary practice location

201 Lephillip Court N.E.
Concord, NC 28025

Mailing address

201 Lephillip Court N.E.
Concord, NC 28025
Phone (704) 782-1127

Other identifiers 2

IdentifierTypeStateIssuer
891260XMedicaidNC
1260XOtherNCBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100902000255 NC Practitioner - Ophthalmology 4486738770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Vanderbilt University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cabarrus Eye Center PAGroup PAC ID 5991735706, 11 clinicians

Practice addresses (Care Compare)

201 Le Phillip CT NE
Concord, NC 28025-2900
Phone (704) 782-1127

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200000505NCMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Surgery and Laser Clinic, Inc. CurrentSince Aug 20, 2010 Accepting new patients
Cabarrus Eye Center PA Ophthalmology CurrentSince Aug 20, 2010 Accepting new patients
Cabarrus Eye Center, PA Past Accepting new patients

Locations

500 Lake Concord Rd NE
Concord, NC 28025
Phone (704) 782-1127

201 Le Phillip Ct NE
Concord, NC 28025
Phone (704) 782-1127

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.

NPI Registry JSON

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274918400000",
    "number": "1497748396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 LEPHILLIP COURT N.E.",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "28025",
            "telephone_number": "704-782-1127",
            "fax_number": "704-782-1207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LEPHILLIP COURT N.E.",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "28025",
            "telephone_number": "704-782-1127",
            "fax_number": "704-782-1207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARK",
        "first_name": "KURT",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2010-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "200000505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891260X",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1260X",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.