Individual provider Active NPI

Kim Korte-Moore, O.D.

  • Optometrist
  • Austintown, OH
National Provider Identifier
1992885412
Registry record updated Apr 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4027T1760 Issued in OH
Practice address
6000 Mahoning Ave
Ste. 394
Austintown, OH 44515-2240
Phone
(330) 797-3120
Fax
(330) 797-3126
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4027T1760 OH Primary

Addresses

Primary practice location

6000 Mahoning Ave
Ste. 394
Austintown, OH 44515-2240

Mailing address

1338 Quail CT
Boardman, OH 44512-8047
Phone (330) 726-8405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20120427000147 OH Practitioner - Optometry 5597927129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optical Solutions 2 LLCGroup PAC ID 4688987225, 4 clinicians

Practice addresses (Care Compare)

6006 Mahoning Ave
Austintown, OH 44515-2239
Phone (330) 797-8780

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4027T1760OHMDOptometrist
4027OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optical Solutions 2 LLC Optometrist CurrentSince Jun 25, 2015 Accepting new patients

Locations

6006 Mahoning Ave
Ste D
Austintown, OH 44515
Phone (330) 797-8780

6006 Mahoning Ave
Youngstown, OH 44515
Phone (330) 797-8780

Organizations & group practices 1

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271376000000",
    "number": "1992885412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1338 QUAIL CT",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445128047",
            "telephone_number": "330-726-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 MAHONING AVE",
            "address_2": "STE. 394",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445152240",
            "telephone_number": "330-797-3120",
            "fax_number": "330-797-3126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORTE-MOORE",
        "first_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2010-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4027T1760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austintown, OH

Sources for this page

Verify at the official NPI Registry.