NPIMap

Organization Active NPI

Kentucky Eye Care PSC

  • Ophthalmology Physician
  • Louisville, KY
National Provider Identifier
1740937960
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
KENTUCKY EYE CARE PSC
Practice address
5202 Preston Hwy
Louisville, KY 40213-2722
Phone
(502) 896-8700
Fax
(502) 896-0813
NPI assigned
Mar 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Authorized official

Name
Mark Aaron Ihnen, MDNPI 1770809212
Title
Physician
Phone
(502) 896-5750

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

5202 Preston Hwy
Louisville, KY 40213-2722

Mailing address

6400 Dutchmans Pkwy Ste 125
Louisville, KY 40205-3342
Phone (502) 896-8700

Other identifiers 1

IdentifierTypeStateIssuer
65918864MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Direct@KentuckyEyeCareLouisvilleKY.CompulinkDirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220411001947 KY DME Supplier - Physician - Ophthalmology 5092798389 Practice locations: Louisville, KY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Kentucky Eye Care PSC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5205 Preston Hwy
Louisville, KY 40213

1169 Eastern Pkwy
Ste 1211
Louisville, KY 40217
Phone (502) 451-7740

13 Village Plz
Shelbyville, KY 40065
Phone (800) 525-0414

Interoperability endpoints

  • Direct secure messaging: direct@kentuckyeyecarelouisvilleky.compulinkdirect.com

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1646697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705968000000",
    "number": "1740937960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 DUTCHMANS PKWY STE 125",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402053342",
            "telephone_number": "502-896-8700",
            "fax_number": "502-896-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5202 PRESTON HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402132722",
            "telephone_number": "502-896-8700",
            "fax_number": "502-896-0813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKY EYE CARE PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-08",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A",
        "authorized_official_last_name": "IHNEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "AARON",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "502-896-5750",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65918864",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Direct@KentuckyEyeCareLouisvilleKY.CompulinkDirect.com",
            "affiliation": "N",
            "address_1": "5202 Preston Hwy",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402132722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.