Kathleen Ann Maes-Pukala, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-008577 Issued in IL

Practice address

841 Industrial Blvd
Smyrna, TN 37167-6865

Phone

(615) 220-6108

NPI assigned

Jul 12, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

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 and National Provider Directory roles.

• Dr. Mark Lynn & Associates, PLLC

  • Optometrist
  • Franklin, TN
  • NPI 1194739490
  Medicare reassignment NPD
• TN Doctors of Optometry, PLLC

  • Optometrist
  • Collierville, TN
  • NPI 1538827050
  Medicare reassignment NPD
• TN Doctors of Optometry, PLLC

  • Eyewear Supplier
  • Kingsport, TN
  • NPI 1275299562

  Optometrist

  NPD
• Ky Doctors of Optometry, PLLC

  • Eyewear Supplier
  • St Matthews, KY
  • NPI 1801610985

  Optometrist

  NPD

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384300800000",
    "number": "1740215383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 INDUSTRIAL BLVD",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676865",
            "telephone_number": "615-220-6108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 INDUSTRIAL BLVD",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676865",
            "telephone_number": "615-220-6108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAES-PUKALA",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2013-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-008577",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3116",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrina L Lynn
• Quintana Lytle
• Kenneth Dale Macknet Jr., M.D.
• Daryl Clinton Madden, PA-C
• Rachael Madu, FNP
• Magnolia Speech Therapy
• Ana Majic
• Christian Maness
• Nelson J Mangione, MD
• Savannah Manley

• Optometrist in Smyrna, TN
• Providers in Smyrna, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.