Douglas J Kimball, DO

Primary specialty

OptometristTaxonomy code 152W00000X

License

559 Issued in MT

Practice address

91 W Madison Ave
Suite B
Belgrade, MT 59714-3901

Phone

(406) 388-1988

Fax

(406) 388-2488

NPI assigned

Jul 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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 3

Medicare fee-for-service enrollment

Enrolled in MT

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

Southern California College of Optometry, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Eyecare LLCGroup PAC ID 0840288056, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.3 of 100Reported as group

Quality

74.6

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: douglas.kimball@direct.revolutionehr.com

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.

• Advanced Eyecare LLC

  • Optometrist
  • Bozeman, MT
  • NPI 1629283155
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932134475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 W MADISON AVE",
            "address_2": "SUITE B",
            "city": "BELGRADE",
            "state": "MT",
            "postal_code": "597143901",
            "telephone_number": "406-388-1988",
            "fax_number": "406-388-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 W MADISON AVE",
            "address_2": "SUITE B",
            "city": "BELGRADE",
            "state": "MT",
            "postal_code": "597143901",
            "telephone_number": "406-388-1988",
            "fax_number": "406-388-2488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "DOUGLAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "25871",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048-3704",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NAT SUPPLIER",
            "identifier": "5276810001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Billy Keffer
• Megan Kemp, DPT, ATC, CSCS
• Bennett Herbert Kern, M.S., LCPC
• Deborah Lee Kern
• Nicole Marie Kieffer
• David B King, MD
• Dane C Kinghorn, DMD
• Jessica Quinton Kirkpatrick, D.V.M
• Heather D Kjerstad, MD
• Kelley Helen Koontz, DPT

• Optometrist in Belgrade, MT
• Providers in Belgrade, MT by specialty
• Optometrist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.