Individual provider Active NPI

Kevin Lloyd Brown, O.D, M.S.

  • Optometrist
  • Mansfield, OH
National Provider Identifier
1619083714
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OH 4548 T1291 Issued in OH
Practice address
1260 Lexington Ave
Mansfield, OH 44907
Phone
(419) 756-8204
Fax
(419) 756-0286
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OH 4548 T1291 OH Primary
Corneal and Contact Management Optometrist 152WC0802X OH 4548 T1291 OH
Pediatric Optometrist 152WP0200X OH 4548 T1291 OH

Addresses

Primary practice location

1260 Lexington Ave
Mansfield, OH 44907

Mailing address

1260 Lexington Ave
Mansfield, OH 44907
Phone (419) 756-8204

Other identifiers 1

IdentifierTypeStateIssuer
2019069MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20130213000234 OH Practitioner - Optometry 3173780079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brown Eyecare LLCGroup PAC ID 2668772526, 3 clinicians

Practice addresses (Care Compare)

1260 Lexington Ave
Mansfield, OH 44907-2675
Phone (419) 252-1207

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
OH 4548 T1291OHMDPediatric Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Brown Eyecare LLC Optometrist CurrentSince Apr 1, 2015 Accepting new patients
Dr. Donald Brown Past Accepting new patients

Locations

70 Park Ave W
Mansfield, OH 44902
Phone (419) 525-1207

1260 Lexington Ave
Mansfield, OH 44907
Phone (419) 252-1207

Organizations & group practices 2

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1619083714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "44907",
            "telephone_number": "419-756-8204",
            "fax_number": "419-756-0286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "44907",
            "telephone_number": "419-756-8204",
            "fax_number": "419-756-0286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KEVIN",
        "middle_name": "LLOYD",
        "name_prefix": "Dr.",
        "credential": "O.D, M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OH 4548 T1291",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OH",
            "license": "OH 4548 T1291",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "OH",
            "license": "OH 4548 T1291",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2019069",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

Verify at the official NPI Registry.