Edward B Brockman (NPI# 1861490146, PAC ID# 2264326800) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPHTHALMOLOGY.
| Nation Provider ID (NPI) | 1861490146 |
| PAC ID by PECOS | 2264326800 |
| Professional Enrollment ID | I20040503001145 |
| Full Name | Edward B Brockman |
| Organization Legal Name | JOHN KENYON AMERICAN EYE INSTITUTE, LLC |
| Address |
206 W John Fitch Ave Bardstown KY 40004-1115 |
| Phone Number | 8003425393 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE |
| Graduation Year | 1986 |
| Primary Specialty | OPHTHALMOLOGY |
| Group Practice PAC ID | 5496640351 |
| Number of Group Practice Members | 9 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 180012 | HARDIN MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 206 W John Fitch Ave, Bardstown, KY 40004-1115 | 8003425393 | JOHN KENYON AMERICAN EYE INSTITUTE, LLC |
| 335 New Towne Rd, Bowling Green, KY 42103-7966 | 8003425393 | JOHN KENYON AMERICAN EYE INSTITUTE, LLC |
| 103 Diecks Dr, Elizabethtown, KY 42701-2444 | 8003425393 | JOHN KENYON AMERICAN EYE INSTITUTE, LLC |
| 1303 Us Hwy 127 S 108, Frankfort, KY 40601-4385 | 8003425393 | JOHN KENYON AMERICAN EYE INSTITUTE, LLC |
| 299 Kings Daughters Dr, Frankfort, KY 40601-6514 | 5028755240 | JOHN KENYON AMERICAN EYE INSTITUTE, LLC |
| 115 Columbia Ave, Glasgow, KY 42141-2903 | 8003425393 | JOHN KENYON AMERICAN EYE INSTITUTE, LLC |
| 109 S Walters Ave, Hodgenville, KY 42748-1533 | 8003425393 | JOHN KENYON AMERICAN EYE INSTITUTE, LLC |
| 1305 Wall St, Suite 200, Jeffersonville, IN 47130-3853 | 8122889011 | JOHN KENYON AMERICAN EYE INSTITUTE, LLC |
| 2525 Elizabethtown Rd, Leitchfield, KY 42754-9120 | 8003425393 | JOHN KENYON AMERICAN EYE INSTITUTE, LLC |
| 31 Bobby Bland Way, Leitchfield, KY 42754-1744 | 8003425393 | JOHN KENYON AMERICAN EYE INSTITUTE, LLC |
| 100 W Market St, Louisville, KY 40202-1332 | 8129480616 | JOHN KENYON AMERICAN EYE INSTITUTE, LLC |
| 120 W Market St, Louisville, KY 40202-1332 | 8129480616 | JOHN KENYON AMERICAN EYE INSTITUTE, LLC |
| 4040 Dutchmans Ln B, Louisville, KY 40207-4712 | 5028952910 | JOHN KENYON AMERICAN EYE INSTITUTE, LLC |
| 815 Main St, Munfordville, KY 42765-9423 | 8003425393 | JOHN KENYON AMERICAN EYE INSTITUTE, LLC |
| 519 State St, New Albany, IN 47150-3620 | 8129480616 | JOHN KENYON AMERICAN EYE INSTITUTE, LLC |
| 2200 E Parrish Ave, Suite 101, Owensboro, KY 42303-1449 | 8003425393 | JOHN KENYON AMERICAN EYE INSTITUTE, LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_012_overall | Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation | 100% | |
| MIPS_EC_014_overall | Age-Related Macular Degeneration (AMD): Dilated Macular Examination | 100% | |
| MIPS_EC_111_overall | Pneumococcal Vaccination Status for Older Adults | 46% | |
| MIPS_EC_117_overall | Diabetes: Eye Exam | 99% | |
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 100% | |
| MIPS_EC_140_overall | Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement | 100% | |
| MIPS_EC_226_overall | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 100% |
| Organization Legal Name | JOHN KENYON AMERICAN EYE INSTITUTE, LLC |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kaylea J. Percal | Optometry | John Kenyon American Eye Institute, LLC | 519 State St, New Albany, IN 47150-3620 |
| Randall L Noblitt | Optometry | John Kenyon American Eye Institute, LLC | 1305 Wall St, Suite 200, Jeffersonville, IN 47130-3853 |
| Howard Steven Lazarus | Ophthalmology | John Kenyon American Eye Institute, LLC | 4040 Dutchmans Ln B, Louisville, KY 40207-4712 |
| Steven M Wilson | Optometry | John Kenyon American Eye Institute, LLC | 4040 Dutchmans Ln B, Louisville, KY 40207-4712 |
| Meghan N Gambrel | Optometry | John Kenyon American Eye Institute, LLC | 519 State St, New Albany, IN 47150-3620 |
| Asim R Piracha | Ophthalmology | John Kenyon American Eye Institute, LLC | 4040 Dutchmans Ln B, Louisville, KY 40207-4712 |
| Shiraaz I Rahman | Ophthalmology | John Kenyon American Eye Institute, LLC | 519 State St, New Albany, IN 47150-3620 |
| Jessica Sue Finch Crouch | Optometry | John Kenyon American Eye Institute, LLC | 519 State St, New Albany, IN 47150-3620 |
| Street Address |
206 W JOHN FITCH AVE |
| City | BARDSTOWN |
| State | KY |
| Zip | 40004-1115 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Thomas G Brelage | Optometry | 206 W John Fitch Ave, Bardstown, KY 40004-1115 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Charlotte L Adams | Nurse Practitioner | Communicare Inc | 331 S 3rd St, Bardstown, KY 40004-1032 |
| Karel E Disponett | Psychologist, Clinical | Communicare Inc | 331 S 3rd St, Bardstown, KY 40004-1032 |
| Theresa G Johns | Clinical Social Worker | Communicare Inc | 331 S 3rd St, Bardstown, KY 40004-1032 |
| Thomas Brown | Psychiatry | Communicare Inc | 331 S 3rd St, Bardstown, KY 40004-1032 |
| Darren Morgan Patrick | Optometry | Patrick Eye Care Pllc | 115 S 5th St, Bardstown, KY 40004-1108 |
| Holly R Schat | Optometry | Clarkson Optometry Midwest Inc | 115 S 5th St Bardstown, Bardstown, KY 40004-1108 |
| Stephanie Leon | Chiropractic | 214 W John Fitch Ave, Bardstown, KY 40004-1115 | |
| David Rodriguez | Diagnostic Radiology | Hardin Professional Services, LLC | 201 S 5th St, Bardstown, KY 40004-1142 |
| David M. Sindler | Family Medicine | Hardin Professional Services, LLC | 201 S 5th St, Bardstown, KY 40004-1142 |
| Ronald D Tyler | Pediatric Medicine | Bardstown Primary Care Pllc | 201 S 5th St, Bardstown, KY 40004-1142 |
| Find all physicians in zip 40004 | |||
| City | BARDSTOWN |
| Zip Code | 40004 |
| Specialty | OPHTHALMOLOGY |
| City + Specialty | BARDSTOWN + OPHTHALMOLOGY |
Please comment or provide details below to improve the information on Edward B Brockman.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.