Individual provider Active NPI

Seth P Kresovsky, MD

  • Ophthalmology Physician
  • Lafayette, IN
National Provider Identifier
1780856716
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
01064881A Issued in IN
Practice address
1345 Unity PL
Suite 245
Lafayette, IN 47905-5770
Phone
(765) 446-5130
Fax
(765) 446-5131
NPI assigned
Mar 31, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 01064881A IN Primary

Addresses

Primary practice location

1345 Unity PL
Suite 245
Lafayette, IN 47905-5770

Mailing address

PO Box 4699
Lafayette, IN 47903-4699
Phone (765) 449-2732

Other identifiers 2

IdentifierTypeStateIssuer
000000586923OtherINANTHEM
200917460MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081016000582 IN Practitioner - Ophthalmology 2062581630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Indiana University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unity Healthcare LLCGroup PAC ID 0244123362, 62 clinicians

Practice addresses (Care Compare)

1250 S Creasy LN
Suite a
Lafayette, IN 47905-4960
Phone (765) 446-5417

1345 Unity PL
Lafayette, IN 47905-5761

1345 Unity PL
Suite 245
Lafayette, IN 47905-5770
Phone (765) 446-5130

166 Sagamore Pkwy W
Garan Chadha MD
West Lafayette, IN 47906-1569
Phone (765) 449-2458

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery653

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Healthcare LLC CurrentSince Aug 1, 2008 Accepting new patients
Unity Healthcare, LLC Ophthalmology Current Accepting new patients
Unity Healthcare LLC Past Accepting new patients
Unity Healthcare, LLC Ophthalmology Past Accepting new patients

Locations

1345 Unity Pl
Ste 245
Lafayette, IN 47905
Phone (765) 446-5130

1345 Unity Pl
Ste 235
Lafayette, IN 47905
Phone (765) 446-5065

152 Sagamore Pkwy W
West Lafayette, IN 47906
Phone (765) 423-6556

Interoperability endpoints

  • Direct secure messaging: seth.kresovsky@burgettkresovskyeye.direct.eyemdemr.com

Organizations & group practices 4

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": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1780856716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4699",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479034699",
            "telephone_number": "765-449-2732",
            "fax_number": "765-449-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 UNITY PL",
            "address_2": "SUITE 245",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055770",
            "telephone_number": "765-446-5130",
            "fax_number": "765-446-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRESOVSKY",
        "first_name": "SETH",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-31",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "01064881A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000586923",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200917460",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.