Dr Krystyn Kudla, OD - Medicare Optometrist in Detroit, MI

Dr Krystyn Kudla, OD is a medicare enrolled "Optometrist" provider in Detroit, Michigan. Her current practice location is 4646 John R St, Detroit, Michigan. You can reach out to her office (for appointments etc.) via phone at (313) 576-1000.

Dr Krystyn Kudla is licensed to practice in Michigan (license number 4901004896) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1164805099.

Contact Information

Dr Krystyn Kudla, OD
4646 John R St,
Detroit, MI 48201-1916
(313) 576-1000
Not Available



Healthcare Provider's Profile

Full NameDr Krystyn Kudla
GenderFemale
SpecialityOptometrist
Location4646 John R St, Detroit, Michigan
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1164805099
  • Provider Enumeration Date: 07/09/2015
  • Last Update Date: 01/15/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 4082973177
  • Enrollment ID: I20180118000301

Medical Identifiers

Medical identifiers for Dr Krystyn Kudla such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1164805099NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist 4901004896 (Michigan)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Krystyn Kudla allows following entities to bill medicare on her behalf.
Provider NameLake Lazer Eye Center Pc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1003951575
PECOS PAC ID: 2264535152
Enrollment ID: O20070314000217

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Provider NameClarity Advanced Eyecare Pllc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1639582919
PECOS PAC ID: 7416177894
Enrollment ID: O20141007001415

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Provider NameClarity Eye Contact Pllc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1386340180
PECOS PAC ID: 1052777067
Enrollment ID: O20230517002854

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Provider NameClarity Oakland Wl Pllc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1336845122
PECOS PAC ID: 5991161812
Enrollment ID: O20230519000769

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Krystyn Kudla is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Krystyn Kudla, OD
35776 Harper Ave,
Clinton Township, MI 48035-3212

Ph: (586) 792-3891
Dr Krystyn Kudla, OD
4646 John R St,
Detroit, MI 48201-1916

Ph: (313) 576-1000

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› Verified 2 days ago


Optometrist in Detroit, MI

Dr. Robert Fredrick Lee Iii, O.D.
Optometrist
Medicare: Medicare Enrolled
Practice Location: 15157 Gratiot Ave, Detroit, MI 48205
Phone: 313-526-7664    Fax: 313-526-2055
Dr. Sura Hassan, OD
Optometrist
Medicare: Medicare Enrolled
Practice Location: 4717 St. Antoine, Kresge Eye Institute, Detroit, MI 48201
Phone: 313-577-8900    Fax: 313-577-0700
Dr. Richard Edwin Gay, OD
Optometrist
Medicare: Medicare Enrolled
Practice Location: 19173 Mack Ave, Detroit, MI 48230
Phone: 313-882-7883    Fax: 313-882-5128
Heritage Optical Inc.
Optometrist
Medicare: Not Enrolled in Medicare
Practice Location: 2678 E Jefferson Ave, Detroit, MI 48207
Phone: 313-259-6006    
Dr. Linda Le,
Optometrist
Medicare: Not Enrolled in Medicare
Practice Location: 1301 Orleans St Apt 1705, Detroit, MI 48207
Phone: 248-759-9202    
Wayne State University Physician Group
Optometrist
Medicare: Not Enrolled in Medicare
Practice Location: 4717 Saint Antoine St, Detroit, MI 48201
Phone: 313-577-8900    Fax: 313-577-0700
Heritage Optical Center, Inc.
Optometrist
Medicare: Not Enrolled in Medicare
Practice Location: 19010 Livernois Ave, Detroit, MI 48221
Phone: 313-863-9581    

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