Individual provider Active NPI

Susanne Sydow Kilgo, OD

  • Optometrist
  • Asheville, NC
National Provider Identifier
1558400655
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0989 Issued in NC
Practice address
2 Walden Ridge Dr Ste 50
Asheville, NC 28803
Phone
(828) 676-3260
Fax
(828) 676-3258
NPI assigned
Feb 5, 2007
Last updated
Jun 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0989 NC Primary

Addresses

Primary practice location

2 Walden Ridge Dr Ste 50
Asheville, NC 28803

Mailing address

2 Walden Ridge Dr Ste 50
Asheville, NC 28803-8598
Phone (828) 676-3260

Other practice location 1

300 Julian Ln
Arden, NC 28704-7809
Phone (828) 650-2727

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040809001149 NC Practitioner - Optometry 8921070152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2 Walden Ridge Dr
Suite 50
Asheville, NC 28803-8598
Phone (828) 676-3260

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0989NCMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kilgo Eye Care OD PLLC Optometrist CurrentSince Oct 22, 2018 Accepting new patients

Locations

2 Walden Ridge Dr
Ste 50
Asheville, NC 28803
Phone (828) 676-3260

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, 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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1558400655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WALDEN RIDGE DR STE 50",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288038598",
            "telephone_number": "828-676-3260",
            "fax_number": "828-676-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WALDEN RIDGE DR STE 50",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "28803",
            "telephone_number": "828-676-3260",
            "fax_number": "828-676-3258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Julian Ln",
            "address_purpose": "LOCATION",
            "city": "Arden",
            "state": "NC",
            "postal_code": "287047809",
            "country_code": "US",
            "telephone_number": "828-650-2727",
            "fax_number": "828-650-2725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILGO",
        "first_name": "SUSANNE",
        "middle_name": "SYDOW",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "0989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

Verify at the official NPI Registry.