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Deactivated NPI 1104825900 Deactivated / Inactive NPI Male Practitioner

Dr. John David Mckenna , OD

Optometrist • Indianapolis, IN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. John Mckenna has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 14, 2005
NPI Deactivation Date March 17, 2006
Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. John Mckenna, OD was a registered Optometrist practicing in Indianapolis, IN. Throughout an active medical career spanning 1 years, Dr. Mckenna provided care at the practice location at 1511 N POST RD until profile deactivation on 2006-03-17.

Historical Medicare Part B clinical services included photography of the retina, established patient complete exam of visual system, established patient outpatient office visit. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

1511 N Post Rd

Indianapolis, IN 462194247

Telephone 3178991017
Fax 3178991660
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Indianapolis, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 17.0 Yrs
State Avg: 22.8 Yrs
Regional Practice Density
233 Specialists

Practicing in Indianapolis, IN (1644 Statewide)

Telehealth Adoption Rate
0.4% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
20.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2022)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
92250 Photography of the retina
20 20 $67.50 $33.09
92014 Established patient complete exam of visual system
12 12 $125.00 $119.31

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License IN 18003120B

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Kiersten Wytovak

Optometrist

NPI 1386317006

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
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NPI Profile Deactivated October 16, 2024

Record deactivated on October 16, 2024

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Updated Practice Location August 03, 2012

Registered at 1511 N POST RD, INDIANAPOLIS, IN 462194247 (Tel: 3178991017)

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Updated Business Mailing Address August 03, 2012

Registered at 1511 N POST RD, INDIANAPOLIS, IN 462194247 (Tel: 3178991017)

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Provider Name / Credentials Updated August 03, 2012

Recorded as JOHN MCKENNA, O.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 03, 2012

Optometrist (License #18003120B in IN)

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NPI Profile Reactivated March 31, 2006

Record officially reactivated for active practice on March 31, 2006

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NPI Profile Deactivated March 17, 2006

Record deactivated on March 17, 2006

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Initial NPI Registration & Enumeration July 14, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104825900
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 14, 2005
Last Update: August 03, 2012
Deactivation Date: March 17, 2006

Mailing Address

1511 N Post Rd

Indianapolis, IN 462194247

Phone: 3178991017

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.