Katie Lynn Kyles, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3986-35 Issued in WI

Practice address

2330 S Oneida St Ste 102
Green Bay, WI 54304-5118

Phone

(920) 499-3937

NPI assigned

Dec 1, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, WI2 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

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Modern Eyes LTD.Group PAC ID 3274695267, 4 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.

• Modern Eyes LTD.

  • Optometrist
  • Green Bay, WI
  • NPI 1811132830
  Medicare reassignment Care Compare group NPD
• Curators of the University of Missouri

  • Optometrist
  • Saint Louis, MO
  • NPI 1679664718
  Medicare reassignment NPD
• Curators of the University of Missouri

  • Community/Retail Pharmacy
  • Jefferson City, MO
  • NPI 1740083641
  NPD

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

{
    "created_epoch": "1701388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1962278747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 S ONEIDA ST STE 102",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045118",
            "telephone_number": "920-499-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 S ONEIDA ST STE 102",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045118",
            "telephone_number": "920-499-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYLES",
        "first_name": "KATIE",
        "middle_name": "LYNN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-01",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2023047487",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3986-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Mae Kurtz, BCBA
• Kathlene A Kusiv, D.O.
• Jesse F Kusserow, LPC
• Adam Ray Kuten, MD
• Russel J Kuzel, MD
• Dawn Marie La Luzerne, M.S., CCC-SLP
• La Sante Wisconsin Inc.
• Ann M Laake, MD
• William David Laakso, PSY.D.
• Michele Laatsch, APNP

• Optometrist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.