NPIMap

Organization Active NPI

Kentucky Eye Care PSC

  • Ophthalmology Physician
  • Louisville, KY
National Provider Identifier
1588748784
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
KENTUCKY EYE CARE PSC
Practice address
6400 Dutchmans Pkwy
Ste 125
Louisville, KY 40205-3340
Phone
(502) 896-8700
Fax
(502) 896-0813
NPI assigned
Oct 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Authorized official

Name
Mark Aaron Ihnen, MDNPI 1770809212
Title
Physician
Phone
(502) 896-5750

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

6400 Dutchmans Pkwy
Ste 125
Louisville, KY 40205-3340

Mailing address

6400 Dutchmans Pkwy
Ste 125
Louisville, KY 40205-3340
Phone (502) 896-8700

Other identifiers 2

IdentifierTypeStateIssuer
65918864MedicaidKY
CI0134OtherKYRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040608001361 KY Part B Supplier - Clinic/Group Practice 5092798389 Receives reassigned benefits from 14 practitioners
Practice locations: Louisville, KY
O20100930088950 KY DME Supplier - Physician - Ophthalmology 5092798389 1 other NPI on this enrollment
Practice locations: Louisville, KY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Kentucky Eye Care PSC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

300 W John Fitch Ave
#100
Bardstown, KY 40004
Phone (502) 447-4500

6400 Dutchmans Pkwy
Ste 125
Louisville, KY 40205

5141 Dixie Hwy
Ste 102
Louisville, KY 40216
Phone (502) 448-1546

189 Adam Shepherd Pkwy
Ste 20
Shepherdsville, KY 40165
Phone (502) 215-7094

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705968000000",
    "number": "1588748784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 DUTCHMANS PKWY",
            "address_2": "STE 125",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402053340",
            "telephone_number": "502-896-8700",
            "fax_number": "502-896-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 DUTCHMANS PKWY",
            "address_2": "STE 125",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402053340",
            "telephone_number": "502-896-8700",
            "fax_number": "502-896-0813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKY EYE CARE PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A",
        "authorized_official_last_name": "IHNEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "AARON",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "502-896-5750",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65918864",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI0134",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.