Gage Michael Koon, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

18004649A Issued in IN

Practice address

13197 State Road 23
Granger, IN 46530-9225

Phone

(574) 247-1500

Fax

(574) 247-1505

NPI assigned

Jun 15, 2026

Sex

Male

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

Not listed in the public Medicare enrollment file

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.

Specialty

Optometry

Education

Indiana University - School of Optometry, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1781481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1508791369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13197 STATE ROAD 23",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465309225",
            "telephone_number": "574-247-1500",
            "fax_number": "574-247-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13197 STATE ROAD 23",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465309225",
            "telephone_number": "574-247-1500",
            "fax_number": "574-247-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOON",
        "first_name": "GAGE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-15",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004649A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen Klinedinst, MA EDS
• Amy Wolfe Knauff, MA CCC/SLP
• Marcia A Koelndorfer, LCSW
• Sarah Ann Kolacz, NP
• Walter Douglas Kolmodin, DPM
• Payal Koul-Kumar, PT
• Hannah Kovac
• Elizabeth Kresse, PT
• Kevin R Kristl, M.D.
• Marion Kuczmanski, REGISTERED PHARMACIS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; 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.