Individual provider Active NPI

Kimberly Anne Esposito, OD

  • Optometrist
  • Michigan City, IN
National Provider Identifier
1871013250
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004058A Issued in IN
Practice address
5780 Franklin St
Michigan City, IN 46360-7844
Phone
(219) 879-4390
NPI assigned
Jun 26, 2017
Last updated
Oct 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046011129 IL
Optometrist 152W00000X 18004058A IN Primary

Addresses

Primary practice location

5780 Franklin St
Michigan City, IN 46360-7844

Mailing address

PO Box 2081
Valparaiso, IN 46384-2081
Phone (219) 879-4390

Other names 1

  • Kimberly Harmon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171013003041 IL Practitioner - Optometry 6305111576 Reassigns benefits to 1 organization
I20190927001071 IN Practitioner - Optometry 6305111576 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046011129ILMDOptometrist
18004058AINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Indiana, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist CurrentSince Jan 4, 2021 Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Jan 10, 2022 Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist CurrentSince Jan 4, 2021 Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Jan 10, 2022 Accepting new patients
Andrew F. Mansueto, O.D. PastSince Sep 15, 2019 Accepting new patients

Locations

5408 N Clark St
Chicago, IL 60640
Phone (773) 275-2020

10550 S Cicero Ave
Oak Lawn, IL 60453
Phone (708) 499-3911

528 Indian Boundary Rd
Chesterton, IN 46304
Phone (219) 250-2470

9760 Lantern Rd
Fishers, IN 46037
Phone (317) 577-9200

422 Perry St
La Porte, IN 46350
Phone (219) 325-0404

3701 Franklin St
Michigan City, IN 46360
Phone (219) 872-8844

6097 US Highway 6
Portage, IN 46368
Phone (219) 730-4559

2106 Calumet Ave
Valparaiso, IN 46383
Phone (219) 464-8200

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1871013250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2081",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463842081",
            "telephone_number": "219-879-4390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5780 FRANKLIN ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607844",
            "telephone_number": "219-879-4390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPOSITO",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-26",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011129",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004058A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "HARMON",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Michigan City, IN

Sources for this page

Verify at the official NPI Registry.