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DR. HENRY J KAPLAN M.D.
NPI 1104851864
Ophthalmology in Louisville, KY

Active since July 11, 2006PECOS EnrolledAccepts Medicare Assignment
81.57/100
CMS Quality Rating
4121 DUTCHMANS LN, SUITE 410, LOUISVILLE, KY 40207(502) 897-9881(502) 897-9824 Get Directions Write a Review

NPPES record last updated: August 18, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Henry J Kaplan M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. HENRY J KAPLAN M.D. (NPI 1104851864) is an individual ophthalmology provider in Louisville, Kentucky, licensed in Kentucky (36464) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Ssm Health Saint Louis University Hospital, and is a graduate of Js Weill Medical College, Cornell University (1968).

NPPES Registry Identity

NPI1104851864
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. HENRY J KAPLANCredential: M.D.
Location Address4121 DUTCHMANS LN, SUITE 410Louisville, KY 40207-4707
Mailing Address301 E Muhammad Ali BlvdLouisville, KY 40202-1511 · (502) 852-5466 · Fax (502) 852-4947
Phone(502) 897-9881
Fax(502) 897-9824
Sole ProprietorNo
Medical School CMSJs Weill Medical College, Cornell UniversityGraduated 1968
Enumeration DateJuly 11, 2006
Last NPPES UpdateAugust 18, 2010
✔ NPI 1104851864 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in KY · 36464
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
4121 DUTCHMANS LN, Louisville, KY 40207
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Other Identifiers 4

Medicaid64030984KY
Medicare PIN536805KY
Medicaid200143570IN
Medicare PIN0075550KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Henry J Kaplan M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8921911470
PECOS Enrollment IDI20201103002061
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
57 services38 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
41 services33 patients
Extended exam of the back part of the eye with optic nerve drawing 92202
This procedure involves a detailed examination of the back part of your eye, focusing on the optic nerve, a crucial component for vision. A drawing or map of the optic nerve is created to help track any changes over time. This can help detect eye diseases early.
33 services23 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
13 services12 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ssm Health Saint Louis University Hospital

Acute Care Hospitals · Saint Louis, MO
1/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number260105
Location3635 Vista AveSaint Louis, MO 63110 · St. Louis City County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40207 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
Established Patient
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.57/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality76.09
Promoting Interoperability100
Improvement Activities40
Cost54.28

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THOMAS W. BENNINGER PLLC
Obstetrics & Gynecology (Gynecology)
4121 DUTCHMANS LN, SUITE 101
LOUISVILLE, KY 40207
Jefferson County (502) 897-9416
ASSOCIATES IN OBSTETRICS AND GYNECOLOGY OF LOUISVILLE, PLLC
Obstetrics & Gynecology
4121 DUTCHMANS LN, SUITE 300
LOUISVILLE, KY 40207
Jefferson County (502) 899-6700
DR. JEFFREY W. ALLEN MD
Surgery
4121 DUTCHMANS LN, STE 503
LOUISVILLE, KY 40207
Jefferson County (502) 899-6405
DR. SYLVIA L BEIMFOHR MD
Obstetrics & Gynecology (Gynecology)
4121 DUTCHMANS LN, SUITE 300
LOUISVILLE, KY 40207
Jefferson County (502) 899-6755
SONAL COCHRAN P.A.
Physician Assistant
4121 DUTCHMANS LN, SUITE 606
LOUISVILLE, KY 40207
Jefferson County (502) 869-9877
CORBETT COSMETIC SURGERY
Plastic Surgery
4121 DUTCHMANS LN, SUITE 305
LOUISVILLE, KY 40207
Jefferson County (502) 721-0330
LOUSVILLE UROGYNECOLOGY PLLC
Obstetrics & Gynecology
4121 DUTCHMANS LN, SUITE 401
LOUISVILLE, KY 40207
Jefferson County (502) 895-0557
GERALD D VERDI DDS MD PLLC
Surgery (Plastic and Reconstructive Surgery)
4121 DUTCHMANS LN, STE 311
LOUISVILLE, KY 40207
Jefferson County (502) 895-5555

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Henry Kaplan's NPI number?

The NPI number for Henry Kaplan is 1104851864. It was assigned to this individual provider in the NPPES registry on July 11, 2006.

Where is Henry Kaplan located?

Henry Kaplan practices at 4121 Dutchmans Ln Suite 410, Louisville, KY 40207. The listed phone number is (502) 897-9881.

What is Henry Kaplan's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Henry Kaplan enrolled in Medicare?

Yes. Henry Kaplan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Henry Kaplan accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 4 other insurers list Henry Kaplan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Henry Kaplan affiliated with any hospitals?

According to CMS data, Henry Kaplan is affiliated with Ssm Health Saint Louis University Hospital.

When was this NPI record last updated?

The NPPES record for Henry Kaplan was last updated on August 18, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.