Kyle D Martin, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

6847 Issued in OH

Practice address

391 Lincoln Park Dr
New Lexington, OH 43764-1080

Phone

(740) 342-1784

Fax

(740) 342-1791

NPI assigned

May 8, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Optometry

Education

Ohio State University - College of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chris a. Smiley, O.D. and Associates, LLCGroup PAC ID 0244133866, 10 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Vision Professionals

  • Optometrist
  • Columbus, OH
  • NPI 1972776870
  Medicare reassignment Care Compare group NPD
• Vision Professionals Delaware LLC

  • Optometrist
  • Delaware, OH
  • NPI 1487127163
  Medicare reassignment NPD
• Vision Professionals

  • Optometrist
  • Grove City, OH
  • NPI 1164187274
  NPD
• Vision Professionals

  • Optometrist
  • Sunbury, OH
  • NPI 1972358539
  NPD
• Chris a. Smiley, O.D. and Associates, LLC

  • Optometrist
  • New Albany, OH
  • NPI 1790039881
  NPD (past)
• Robert J. Dittoe, O.D., Inc.

  • Optometrist
  • New Lexington, OH
  • NPI 1710064894
  NPD (past)

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

{
    "created_epoch": "1588896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1760004071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 LINCOLN PARK DR",
            "city": "NEW LEXINGTON",
            "state": "OH",
            "postal_code": "437641080",
            "telephone_number": "740-342-1784",
            "fax_number": "740-342-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 LINCOLN PARK DR",
            "city": "NEW LEXINGTON",
            "state": "OH",
            "postal_code": "437641080",
            "telephone_number": "740-342-1784",
            "fax_number": "740-342-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KYLE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-08",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0452164",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa M Love
• Sharon Christine Lyon-Paul, PMHNP,RN,LISW-S
• Lyons Primary Urgent Care
• Lyons Primary Urgent Care LLC
• John Manard, O.D.
• Penny Sue Maxwell, QMHS
• Donna L. Mayer, CNP
• Stephanie McClelland, NP
• Roger Levi McManis
• Elise M McMath, LISW

• Optometrist in New Lexington, OH
• Providers in New Lexington, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.