COURTNEY NICOLE KASSENBROCK (OD) – Optometrist, NPI 1093121303
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,126 OPTOMETRY in IN
Provider Addresses for COURTNEY NICOLE KASSENBROCK (OD)
105 S Raceway Rd Ste 100
Indianapolis, IN 462311415
Phone: (317) 273-8474
Type: Location
54 MONUMENT CIR
STE 125
INDIANAPOLIS, IN 462042942
Phone: (317) 631-1200
Fax: (317) 631-1600
Type: Location
9795 CROSSPOINT BLVD
STE 100
INDIANAPOLIS, IN 462563354
Phone: (317) 254-6480
Fax: (317) 259-8609
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $241.
Total Amount is formed as General ($241) + Research ($0) + Ownership ($0) = $241.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($176).
Total Amount
$241
General + Research + Ownership
Payments
9
Total payment records
General Amount
$241
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Bausch & Lomb Americas Inc. | $176 |
| ABBVIE INC. | $36 |
| LKC Technologies, Inc. | $15 |
| Novartis Pharmaceuticals Corporation | $14 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-10-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20141014000941 | I | Optometry | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 40 | 25 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 24 | 19 | $0 |
| 92134 | Imaging of retina | 13 | 12 | $0 |
Insurance plans in this area (ZIP 46231)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| OPTOMETRY | IN | 92134 | Diagnostic imaging of retina | 26 | 21 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IN | |
| O P T O M E T R Y | IN | |
| O P T O M E T R Y | IL | |
| O P T O M E T R Y | TN | |
| O P T O M E T R Y | IN | |
| O P T O M E T R Y | IN | |
| O P T O M E T R Y | IN | |
| - | TX | |
| O P T O M E T R Y | IN | |
| O P T O M E T R Y | IN |
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