NPIMap

Individual provider Active NPI

Anthony T Swanholm, OD

  • Optometrist
  • Covington, KY
National Provider Identifier
1609228089
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2057DT Issued in KY
Practice address
1500 James Simpson Jr Way
Covington, KY 41011-0801
Phone
(859) 655-3111
Fax
(859) 655-3110
NPI assigned
Jul 8, 2016
Sex
Male
Sole proprietor
No

Organizations & group practices 17

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.

View all 17

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group Inc 803 clinicians

Practice addresses (Care Compare)

1500 James Simpson Jr Way
Covington, KY 41011-0800
Phone (859) 655-4111

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, KY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160805001549 MI Practitioner - Optometry 1951695451 Reassigns benefits to 1 organization
I20170719000500 KY Practitioner - Optometry 1951695451 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2057DTKYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Oct 5, 2020 Accepting new patients
Clarkson Optometry Midwest Inc Optometrist CurrentSince Sep 1, 2018 Accepting new patients
Summit Medical Group, Inc Optometrist CurrentSince Oct 5, 2020 Accepting new patients
Clarkson Optometry Midwest Inc Optometrist Past Accepting new patients
Cincinnati Eye Care Team LLC Optometrist Past Accepting new patients
20-20 Eyecare PSC Optometrist Past Accepting new patients

Locations

1500 James Simpson Jr Way
Covington, KY 41011
Phone (859) 655-4353

580 S Loop Rd
Edgewood, KY 41017
Phone (859) 301-6000

2498 Dixie Hwy
Ft Mitchell, KY 41017
Phone (513) 863-2938

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

8629 N Pavillion
West Chester, OH 45069
Phone (513) 860-0400

7849 Tylersville Rd
West Chester, OH 45069
Phone (513) 298-5170

Interoperability endpoints

  • Direct secure messaging: anthonyswanholm@direct.eyecare-partners.com
  • Direct secure messaging: aswanholm333154@direct-prd.stelizabeth.com

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.006714 OH
Optometrist 152W00000X 2057DT KY Primary

Addresses

NPPES NPI Registry

Primary practice location

1500 James Simpson Jr Way
Covington, KY 41011-0801

Mailing address

PO Box 635283
Cincinnati, OH 45263-5286
Phone (859) 344-5555

Other practice location 1

105 W 4th St
Cincinnati, OH 45202-2712
Phone (513) 621-2445

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 19, 2021.

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1609228089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635286",
            "telephone_number": "859-344-5555",
            "fax_number": "859-344-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 JAMES SIMPSON JR WAY",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410110801",
            "telephone_number": "859-655-3111",
            "fax_number": "859-655-3110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 W 4th St",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452022712",
            "country_code": "US",
            "telephone_number": "513-621-2445",
            "fax_number": "513-621-2513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWANHOLM",
        "first_name": "ANTHONY",
        "middle_name": "T",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-08",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.006714",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "2057DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, KY

Sources for this page

Verify at the official NPI Registry.