Kyle Koubek, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

006701 Issued in OH

Practice address

26927 Detroit Rd
Westlake, OH 44145-2370

Phone

(440) 892-5367

Fax

(440) 249-5094

NPI assigned

Nov 7, 2018

Last updated

Aug 10, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Madison Eye Care Associates IncGroup PAC ID 9234123084, 7 clinicians

Madison Eye Care of Port Clinton LLCGroup PAC ID 3870957921, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Madison Eye Care of Port Clinton LLC

  dba Madison Eye Care

  • Optometrist
  • Port Clinton, OH
  • NPI 1427748243
  Medicare reassignment Care Compare group NPD Authorized official
• Madison Eye Care Associates Inc

  • Optometrist
  • Westlake, OH
  • NPI 1255473005
  Medicare reassignment Care Compare group NPD
• Cleveland Vision Center II LLC

  dba Cleveland Vision Center

  • Optometrist
  • Parma Heights, OH
  • NPI 1013225150
  NPD
• Sue E. Van Dootingh OD

  • Durable Medical Equipment & Medical Supplies
  • Port Clinton, OH
  • NPI 1780853317
  NPD (past)

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1629546668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26927 DETROIT RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441452370",
            "telephone_number": "440-892-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26927 DETROIT RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441452370",
            "telephone_number": "440-892-5367",
            "fax_number": "440-249-5094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUBEK",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-07",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "006701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Elizabeth Kosileski, DDS
• Sophia Kosmides
• Vernaann M Kotansky
• Kimberly Kotik, LPCC
• Benjamin Martin Kotinsley, MD
• Michael S Kovach, AA
• Gregory Joseph Kovats, O.D.
• Kovesdy Family Eyecare, Inc.
• Matthew Alexander Kowalski, PHARMD
• Tanya Yaneva Koziol, FNP

• Optometrist in Westlake, OH
• Providers in Westlake, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.