Individual provider Active NPI

Kyle Ohman

  • Optometrist
  • Manistee, MI
National Provider Identifier
1740618370
Registry record updated Oct 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2432976 Issued in MI
Practice address
390 8TH St
Manistee, MI 49660-2162
Phone
(231) 679-2479
NPI assigned
Oct 16, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2432976 MI Primary

Addresses

Primary practice location

390 8TH St
Manistee, MI 49660-2162

Mailing address

390 8TH St
Manistee, MI 49660-2162

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20190718000080 IL Practitioner - Optometry 2466775820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

845 Broadmeadow Rd
Rantoul, IL 61866-2119
Phone (217) 892-5095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2432976MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ohman Optometry PLLC Optometrist CurrentSince Nov 17, 2023 Accepting new patients

Locations

845 Broadmeadow Rd
Rantoul, IL 61866
Phone (217) 892-5095

845 Broadmeadow Rd
#100S
Rantoul, IL 61866

100 S High Cross Rd
Urbana, IL 61802
Phone (217) 344-6190

Organizations & group practices 1

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": "1381881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1740618370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 8TH ST",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496602162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 8TH ST",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496602162",
            "telephone_number": "231-679-2479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OHMAN",
        "first_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-16",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "2432976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manistee, MI

Sources for this page

Verify at the official NPI Registry.