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TIMOTHY A SPARKMAN O.D.
NPI 1134409790
Optometrist in Somerset, KY

Active since August 26, 2011PECOS EnrolledAccepts Medicare Assignment
3810 S HIGHWAY 27 STE 1, SOMERSET, KY 42501(606) 678-4551(606) 678-0972 Get Directions Write a Review

NPPES record last updated: May 11, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 11, 2026, Dec 3, 2019, Mar 13, 2017 (3 updates tracked since 2017).

About Timothy A Sparkman O.d. NPPES

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

TIMOTHY A SPARKMAN O.D. (NPI 1134409790) is an individual optometrist in Somerset, Kentucky, licensed in Kentucky (1850DT) and active in the NPI registry since August 2011. He is enrolled in Medicare PECOS, maintains 4 additional practice locations, and is a graduate of Indiana University - School Of Optometry (2011).

NPPES Registry Identity

NPI1134409790
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameTIMOTHY A SPARKMANCredential: O.D.
Location Address3810 S HIGHWAY 27 STE 1Somerset, KY 42501-3073
Mailing AddressPo Box 296Ferguson, KY 42533-0296 · (606) 492-2211 · Fax (606) 676-0873
Phone(606) 678-4551
Fax(606) 678-0972
Sole ProprietorNo
Medical School CMSIndiana University - School Of OptometryGraduated 2011
Enumeration DateAugust 26, 2011
Last NPPES UpdateMay 11, 20263 updates tracked since enumeration
NPPES CertifiedMay 11, 2026
✔ NPI 1134409790 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in KY · 1850DT
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
3810 S HIGHWAY 27 STE 1, Somerset, KY 42501
Open in Google Maps ↗

Secondary Practice Locations 4

Location 1640 W Highway 92 Ste 3Williamsburg, KY 40769-1936 · Phone (606) 549-0464 · Fax (606) 549-0438
Location 2127 Foothills Ave Ste 3Albany, KY 42602-1037 · Phone (606) 387-5612 · Fax (606) 387-6602
Location 3546 Steve DrRussell Springs, KY 42642-4601 · Phone (270) 866-3177 · Fax (270) 866-3155
Location 486 Medical LnWhitley City, KY 42653-4216 · Phone (600) 637-6525 · Fax (606) 376-2045

Other Identifiers 18

Other000000840902KY · Anthem Somerset
Other0487990002KY · Medicare Dme Whitley
Other5094KY · Avesis Whitley
Medicaid7100196570KY
Other4104981TN · Tenncare Whitley
Medicaid7100209960KY
Other015403KY · Block Somerset
Other2416KY · Medicare Somerset
Other5092KY · Avesis Somerset
Other8809KY · Medicare Whitley
OtherCP0230:010KY · Eyemed Somerset
OtherCP0230:009KY · Eyemed Whitley
OtherCB8623KY · Railroad Medicare Ky Offices
OtherCJ5379TN · Railroad Medicare Tn Offices
Other000000840905KY · Anthem Whitley
Other0487990006KY · Medicare Dme Somerset
Other154471TN · Tenncare Somerset
Medicaid7100212600KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Timothy A Sparkman O.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 ID9234303835
PECOS Enrollment IDI20111116000778
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.

Medicare Billing Reassignment

Medicare enrollment records show Timothy Sparkman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Associates In Eye Care, Inc.
0.5 mi
Optometrist
3810 S HWY 27, SUITE 1
Somerset, KY 42501
  • Reassigned Medicare billing, Kentucky enrollment
  • 10 clinicians in this Medicare group
NPI 1649377177 (606) 678-4551

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 8

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.

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.
71 services71 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
64 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.
36 services28 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
35 services35 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
27 services26 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
23 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 42501 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.

Reported Quality Measures

Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
100%26 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES

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

KATHRYN T. WILSON DO
Optometrist
3810 S HIGHWAY 27 STE 1
SOMERSET, KY 42501
Pulaski County (606) 678-4551

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 Timothy Sparkman's NPI number?

The NPI number for Timothy Sparkman is 1134409790. It was assigned to this individual provider in the NPPES registry on August 26, 2011.

Where is Timothy Sparkman located?

Timothy Sparkman practices at 3810 S Highway 27 Ste 1, Somerset, KY 42501. The listed phone number is (606) 678-4551.

What is Timothy Sparkman's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Timothy Sparkman enrolled in Medicare?

Yes. Timothy Sparkman 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.

Which organization bills Medicare for Timothy Sparkman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Timothy Sparkman reassigns Medicare benefits to Associates In Eye Care, Inc. (Somerset, KY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Timothy Sparkman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Timothy Sparkman accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee, Anthem Blue Cross and Blue Shield and Blue Cross Blue Shield of Wyoming and 5 other insurers list Timothy Sparkman 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.

When was this NPI record last updated?

The NPPES record for Timothy Sparkman was last updated on May 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.