Kevin L Crouch, OD

Key facts

NPI

1740324367

Entity type

Individual (NPI type 1)

Primary specialty

Optometrist 152W00000X

License

526 (SD)

Practice address

5118 W 26TH St
Sioux Falls, SD 57106-3520

Phone

(605) 339-1939

Fax

(605) 330-0252

NPI assigned

Feb 16, 2007

Sex

Male

Sole proprietor

No

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.

• Eyecare Specialties of South Dakota, P.C. Optometrist · Sioux Falls, SD · NPI 1942176680
  Medicare reassignment Care Compare group NPD OPTOMETRIST · SD
• Family Eye Care Center, P.C. Optometrist · Sioux Falls, SD · NPI 1932144870
  Medicare reassignment Care Compare group NPD OPTOMETRIST · SD

Medicare Care Compare profile

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1994

Medicare assignment

May accept Medicare assignment

Group practices

Eyecare Specialties of South Dakota PC (9 clinicians)
Family Eye Care Center PC (2 clinicians)

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare participation

Medicare fee-for-service enrollment

Enrolled in SD

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740324367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5118 W 26TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571063520",
            "telephone_number": "605-339-1939",
            "fax_number": "605-330-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5118 W 26TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571063520",
            "telephone_number": "605-339-1939",
            "fax_number": "605-330-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUCH",
        "first_name": "KEVIN",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "526",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02029",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "9231588",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0004141",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA DMERC",
            "identifier": "1250550001",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9201502",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "CV12701",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VSP",
            "identifier": "5118",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIOUX VALLEY HEALTH PLAN",
            "identifier": "30391",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "5214",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ashley R Crouch, OD
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• Katie Sue Cruikshank, SLP
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• CSD Care of SD, LLC
• Brandi Csordacsics, RN

All providers in Sioux Falls, SD · Optometrist in South Dakota