Kevin A. Whiteleather, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

18003140A Issued in IN

Practice address

4201 Lahmeyer Rd
Fort Wayne, IN 46815-5676

Phone

(260) 486-6106

NPI assigned

May 24, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

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

Indiana University - School of Optometry, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Appleseed Eyecare FW Northeast LLCGroup PAC ID 3971087909, 2 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.

• Generations Family Eyecare, PC

  • Optometrist
  • Fort Wayne, IN
  • NPI 1821081621
  Medicare reassignment NPD Authorized official
• Appleseed Eyecare FW Northeast, LLC

  • Optometrist
  • Fort Wayne, IN
  • NPI 1902756133
  Medicare reassignment Care Compare group NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1497758395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 LAHMEYER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468155676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 LAHMEYER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468155676",
            "telephone_number": "260-486-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITELEATHER",
        "first_name": "KEVIN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003140A",
            "primary": true
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "IN",
            "license": "18003140A",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IN",
            "license": "18003140A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "7470288",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS PROVIDER NO.",
            "identifier": "000000225758",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura White, LCSW
• Martin R. White, O.D.
• T Eric White, MD
• Wendy M White, PT
• Jeanne K Whitehead, LCSW, LMFT
• Tracy Dawn Whiteleather, PT
• Jessie M Whiteman, FNP-C
• Whitington Homes & Services for Children and Families, Inc
• Olivia Whitlock
• Amy Whitlow

• Optometrist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.