Individual provider Active NPI

Kyle Frederick Hoskins, OD

  • Optometrist
  • South Bend, IN
National Provider Identifier
1619969649
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002697 Issued in IN
Practice address
17900 Ireland Rd
South Bend, IN 46614-3050
Phone
(574) 291-9280
Fax
(574) 299-1163
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002697 IN Primary

Addresses

Primary practice location

17900 Ireland Rd
South Bend, IN 46614-3050

Mailing address

17900 Ireland Rd
South Bend, IN 46614-3050
Phone (574) 291-9280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20101011001030 IN Practitioner - Optometry 0143335141 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4615 Miami St
Suite 4
South Bend, IN 46614-3264
Phone (574) 855-3834

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002697INMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Hosko PC Optometrist CurrentSince Sep 8, 1994 Accepting new patients

Locations

106 Legacy Plz W
Laporte, IN 46350
Phone (219) 362-2685

4615 Miami St
Ste 4
South Bend, IN 46614
Phone (574) 855-3834

17900 Ireland Rd
South Bend, IN 46614
Phone (574) 291-9280

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1619969649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17900 IRELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466143050",
            "telephone_number": "574-291-9280",
            "fax_number": "574-299-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17900 IRELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466143050",
            "telephone_number": "574-291-9280",
            "fax_number": "574-299-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSKINS",
        "first_name": "KYLE",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.