Individual provider Active NPI

Karl J Luketic, M.D.

  • Ophthalmology Physician
  • Toledo, OH
National Provider Identifier
1669477998
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
35064065 Issued in OH
Practice address
3915 Sunforest CT
Toledo, OH 43623-4453
Phone
(419) 450-3337
NPI assigned
Jun 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 35064065 OH Primary

Addresses

Primary practice location

3915 Sunforest CT
Toledo, OH 43623-4453

Mailing address

3118 Stonegate Dr
Maumee, OH 43537-9423
Phone (419) 450-3337

Other identifiers 6

IdentifierTypeStateIssuer
03297OtherPARAMOUNT
000000127263OtherANTHEM
1451754OtherUNITED HEALTHCARE
0161435MedicaidOH
180035529OtherOHRAILROAD MEDICARE
0005908039OtherAETNA

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101008000152 OH Practitioner - Ophthalmology 8628019528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Northeastern Ohio University College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3915 Sunforest Court
Toledo, OH 43623-4453
Phone (419) 475-9251

Merit-based Incentive Payment System (MIPS)

Final score
86.34 of 100Reported as individual
Quality
76.59
Improvement activities
40
Cost
85.68

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35064065OHMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Luketic Eye Center, LLC Ophthalmology CurrentSince Apr 13, 2012 Accepting new patients
Associated Eye Care Inc Ophthalmology PastSince Dec 1, 2000 Accepting new patients

Locations

3915 Sunforest Ct
Toledo, OH 43623
Phone (419) 475-9251

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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428969600000",
    "number": "1669477998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3118 STONEGATE DR",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435379423",
            "telephone_number": "419-450-3337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 SUNFOREST CT",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234453",
            "telephone_number": "419-450-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKETIC",
        "first_name": "KARL",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2015-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35064065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT",
            "identifier": "03297",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000127263",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1451754",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0161435",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180035529",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005908039",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.