DR. KYLE MAXAM (O.D.) – Optometrist, NPI 1124476411

DR. KYLE MAXAM (O.D.) is a healthcare provider. based in Brookville, Ohio. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 6478 (OH). The NPI Number for DR. KYLE MAXAM (O.D.) is 1124476411

Main info

Male
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
DR. KYLE MAXAM (O.D.)
NPI
1124476411
Phone
(937) 770-1265
Address
430 ARLINGTON RD
Enumeration Date
27 May 2016
Last Update Date
11 July 2025

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI ST LOUIS - SCHOOL OF OPTOMETRY
Secondary Phone
9377701265
Graduation Year
2016 (10 years ago)
PAC ID
3072874890
Group Practice PAC ID
8325308679
Professional Enrollment ID
I20180220001532
Address ID
OH453091103BR430XXRDXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness85
Years active:10State licenses:1Digital endpointsOther names

1,618 OPTOMETRY in OH

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Provider Addresses for DR. KYLE MAXAM (O.D.)

  • 430, Arlington Road, Brookville, Montgomery County, Ohio, 45309, United States

    BROOKVILLE, OH 453091103

    Phone: (937) 770-1265

    Type: Location

  • 430 ARLINGTON RD STE A

    BROOKVILLE, OH 453091103

    Phone: (937) 770-1265

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 28 Open Payments records for all available years, with a total value of $1,000.

Total Amount is formed as General ($1,000) + Research ($0) + Ownership ($0) = $1,000.

Last reported payment date: 2024-11-11 • Largest payer in this snapshot: Johnson & Johnson Vision Care, Inc. ($880).

Total Amount

$1,000

General + Research + Ownership

Payments

28

Total payment records

General Amount

$1,000

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-11

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2018-02-20

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180220001532IOptometryOHTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92014Established patient complete exam of visual system6663$0
92250Photography of the retina4843$0
92004New patient complete exam of visual system3737$0
99213Established patient office or other outpatient visit, 20-29 minutes3020$0
99212Established patient office or other outpatient visit, 10-19 minutes1613$0
View full utilization report →

Insurance plans in this area (ZIP 45309)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8325308679View full group profile
NameSpecialtyState
O P T O M E T R YOH
O P T O M E T R YAZ
O P T O M E T R YOH

Reviews

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Frequently asked questions

Is DR. KYLE MAXAM (O.D.) listed with a National Provider Identifier?
Yes — DR. KYLE MAXAM (O.D.) has NPI 1124476411 on file in the registry.
Would DR. KYLE MAXAM (O.D.) appear as active to a payer?
You can treat DR. KYLE MAXAM (O.D.) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe DR. KYLE MAXAM (O.D.)'s focus?
For DR. KYLE MAXAM (O.D.), the primary taxonomy reads as Optometrist. Clinical services aligned with this taxonomy classification.
Is DR. KYLE MAXAM (O.D.) associated with Brookville?
Public fields place DR. KYLE MAXAM (O.D.) around Brookville, Ohio. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for DR. KYLE MAXAM (O.D.) is noted as May 27, 2016 where the registry provides it.

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