Timothy Gerrit Koop, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

NC1666 Issued in NC

Practice address

1305 Lees Chapel Rd.
Suite 101
Greensboro, NC 27455-2599

Phone

(336) 271-2020

Fax

(336) 275-8200

NPI assigned

Jan 16, 2007

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 NC

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

Indiana University - School of Optometry, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Triad Eye Center OD PAGroup PAC ID 8022918226, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: timothy.koop@uprisedirect.com

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.

• Triad Eye Center OD, PA

  • Optometrist
  • Greensboro, NC
  • NPI 1104966845
  Medicare reassignment Care Compare group NPD Authorized official
• Nova Eye Care OD PA

  • Optometrist
  • Asheboro, NC
  • NPI 1609018019
  NPD (past)
• Triad Eye Associates OD PA

  • Optometrist
  • Archdale, NC
  • NPI 1649228669
  NPD (past)
• Triad Eye Associates of Asheboro OD PA

  • Optometrist
  • Asheboro, NC
  • NPI 1205894292
  NPD (past)
• Triad Eye Associates of High Point OD PA

  • Optometrist
  • High Point, NC
  • NPI 1255399499
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227484800000",
    "number": "1932250834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 LEES CHAPEL RD.",
            "address_2": "SUITE 101",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552599",
            "telephone_number": "336-271-2020",
            "fax_number": "336-275-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 LEES CHAPEL RD.",
            "address_2": "SUITE 101",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552599",
            "telephone_number": "336-271-2020",
            "fax_number": "336-275-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOP",
        "first_name": "TIMOTHY",
        "middle_name": "GERRIT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2008-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "NC1666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890927M",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Paige Kontoulas
• Kathryn Lorraine Kooistra, CNM
• Julius B Koomson
• Tammy Koonce, RN
• Patricia Keaton Koontz, RN
• Yaw Korankyi, PHARMD
• Ben Gerard Kordsmeier, DDS
• Julia Kordsmeier, FNP-C
• Keith G. Kordsmeier, DDS
• Ibrahim Koroma

• Optometrist in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2008; 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.