Individual provider Active NPI

Katherine L Lopez, O.D.

  • Optometrist
  • Indianapolis, IN
National Provider Identifier
1699852061
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002137A Issued in IN
Practice address
54 Monument Cir Ste 125
Indianapolis, IN 46204-3047
Phone
(317) 631-1200
Fax
(317) 631-1600
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002137B IN
Optometrist 152W00000X 18002137A IN Primary

Addresses

Primary practice location

54 Monument Cir Ste 125
Indianapolis, IN 46204-3047

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

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
I20110114001012 IN Practitioner - Optometry 2163611500 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002137AINMDOptometrist
18002137BINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Nov 9, 2021 Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Nov 9, 2021 Accepting new patients

Locations

9760 Lantern Rd
Fishers, IN 46037
Phone (317) 577-9200

5606 E Washington St
Indianapolis, IN 46219
Phone (317) 257-8385

54 Monument Cir
Ste 125
Indianapolis, IN 46204
Phone (317) 631-1200

3902 E 82nd St
Indianapolis, IN 46240
Phone (317) 595-8855

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 3

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1699852061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 MONUMENT CIR STE 125",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462043047",
            "telephone_number": "317-631-1200",
            "fax_number": "317-631-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "KATHERINE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002137B",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002137A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.