Individual provider Active NPI

Kimberly Rosenthal Tinge, O.D.

  • Optometrist
  • Highland, IL
National Provider Identifier
1508893264
Registry record updated May 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046008913 Issued in IL
Practice address
823 9TH St
Highland, IL 62249-1521
Phone
(618) 654-9848
Fax
(618) 654-5200
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046008913 IL Primary

Addresses

Primary practice location

823 9TH St
Highland, IL 62249-1521

Mailing address

132 Ofallon Troy Rd
O Fallon, IL 62269-6702
Phone (618) 628-4446

Other identifiers 1

IdentifierTypeStateIssuer
046008913MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20050310000324 IL Practitioner - Optometry 8123094554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rosenthal Optometric Association LTDGroup PAC ID 7416923842, 2 clinicians

Practice addresses (Care Compare)

823 9TH St
Highland, IL 62249-1521
Phone (618) 654-9848

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rosenthal Optometric Association LTD Optometrist CurrentSince Jul 1, 2002 Accepting new patients

Locations

823 9th St
Highland, IL 62249
Phone (618) 654-2471

Organizations & group practices 1

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274832000000",
    "number": "1508893264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 OFALLON TROY RD",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622696702",
            "telephone_number": "618-628-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 9TH ST",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491521",
            "telephone_number": "618-654-9848",
            "fax_number": "618-654-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINGE",
        "first_name": "KIMBERLY",
        "middle_name": "ROSENTHAL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2010-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008913",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, IL

Sources for this page

Verify at the official NPI Registry.