Individual provider Active NPI

Katharine Wormsley Moles, O.D.

  • Optometrist
  • Munster, IN
National Provider Identifier
1992849749
Registry record updated Mar 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002650B Issued in IN
Practice address
630 Ridge Rd
Munster, IN 46321-1610
Phone
(219) 836-1738
NPI assigned
Feb 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002650B IN Primary

Addresses

Primary practice location

630 Ridge Rd
Munster, IN 46321-1610

Mailing address

630 Ridge Rd
Munster, IN 46321-1610
Phone (219) 836-1738

Other names 1

  • Dr. Katharine Ann Wormsley Former name

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101210000423 IN Practitioner - Optometry 0840487203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evans Eye Care IncGroup PAC ID 9830169234, 33 clinicians

Practice addresses (Care Compare)

449 E Summit St
Eagle Eye Optique
Crown Point, IN 46307-3539
Phone (219) 662-1600

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002650BINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Evans Eye Care Inc Optometrist CurrentSince Oct 12, 2021 Accepting new patients
Duane a Gillam Optometrist Past Accepting new patients

Locations

449 E Summit St
Crown Point, IN 46307
Phone (219) 662-1600

1221 S Creasy Ln
Ste A
Lafayette, IN 47905
Phone (765) 447-4951

3526 Osborne Ln
Lafayette, IN 47909
Phone (765) 447-4951

Interoperability endpoints

  • Direct secure messaging: katharine.moles@direct.revolutionehr.com

Organizations & group practices 2

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": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236816000000",
    "number": "1992849749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 RIDGE RD",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211610",
            "telephone_number": "219-836-1738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 RIDGE RD",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211610",
            "telephone_number": "219-836-1738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLES",
        "first_name": "KATHARINE",
        "middle_name": "WORMSLEY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2009-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002650B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHARINE",
            "last_name": "WORMSLEY",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.