DR. KRYSTYN KUDLA O.D.
NPI 1164805099
Optometrist in Detroit, MI
About Dr. Krystyn Kudla O.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KRYSTYN KUDLA O.D. (NPI 1164805099) is an individual optometrist in Detroit, Michigan, licensed in Michigan (4901004896) and active in the NPI registry since July 2015. She is enrolled in Medicare PECOS and is a graduate of Ferris State College - College Of Optometry (2015).
NPPES Registry Identity
Specialties & Licenses
Accepted 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
Dr. Krystyn Kudla 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.
Medicare Billing Reassignments
4Medicare enrollment records show Krystyn Kudla reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Clinton Twp, MI 48035
- Reassigned Medicare billing, Michigan enrollment
- 4 clinicians in this Medicare group
Birmingham, MI 48009
- Reassigned Medicare billing, Michigan enrollment
- 5 clinicians in this Medicare group
Walled Lake, MI 48390
- Reassigned Medicare billing, Michigan enrollment
- 6 clinicians in this Medicare group
Waterford, MI 48327
- Reassigned Medicare billing, Michigan enrollment
- 2 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 48201 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
DETROIT, MI 48201
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 Krystyn Kudla's NPI number?
The NPI number for Krystyn Kudla is 1164805099. It was assigned to this individual provider in the NPPES registry on July 9, 2015.
Where is Krystyn Kudla located?
Krystyn Kudla practices at 4646 John R St, Detroit, MI 48201. The listed phone number is (313) 576-1000.
What is Krystyn Kudla's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Krystyn Kudla enrolled in Medicare?
Yes. Krystyn Kudla 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 organizations bill Medicare for Krystyn Kudla's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Krystyn Kudla reassigns Medicare benefits to 4 organizations: Lake Lazer Eye Center PC (Clinton Twp, MI), Clarity Advanced Eyecare, PLLC (Birmingham, MI), Clarity Oakland Wl, PLLC (Walled Lake, MI) and Clarity Eye Contact, PLLC (Waterford, MI). Each 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 Krystyn Kudla's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Krystyn Kudla accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Blue Care Network of Michigan and 14 other insurers list Krystyn Kudla 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 Krystyn Kudla was last updated on January 15, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Dr. Krystyn Kudla, O.D. · NPI 1164805099
Optometrist provider in Detroit, Michigan. Individual provider, active in the CMS NPPES registry since July 9, 2015.
## Identity
- **NPI:** 1164805099 (Entity type: Individual)
- **Enumerated:** July 9, 2015
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** 4901004896 (Michigan)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 4646 JOHN R ST, Detroit, MI 48201-1916
- **Phone:** (313) 576-1000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Lake Lazer Eye Center PC (NPI 1003951575, Clinton Twp, MI); Clarity Advanced Eyecare, PLLC (NPI 1639582919, Birmingham, MI); Clarity Oakland Wl, PLLC (NPI 1336845122, Walled Lake, MI); Clarity Eye Contact, PLLC (NPI 1386340180, Waterford, MI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Ferris State College - College Of Optometry, class of 2015
## Record status
- **NPPES last updated:** January 15, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1164805099) · Data from the CMS NPPES public registry.