Active NPI 1609228089 Individual Practitioner Male Practitioner

Dr. Anthony T Swanholm , OD

Optometrist • Covington, KY

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Anthony Swanholm, OD is a certified Optometrist practicing in Covington, KY. With approximately 10 years of clinical experience since graduating from Pacific University - College Of Optometry in 2016, Dr. Swanholm delivers high-quality medical care to the local community at 1500 JAMES SIMPSON JR WAY.

Dr. Swanholm is affiliated with Summit Medical Group Inc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, imaging of retina. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1500 James Simpson Jr Way

Covington, KY 410110801

Telephone 8596553111

Fax 8596553110

Associated Practice Facility / Clinic

🏢 Bluegrass Dialysis Llc Facility NPI 1255566444

Medicare Profile & Education

Medical School

Pacific University - College Of Optometry

Graduation Year

2016

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Covington, KY

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

10 Yrs Matches City Avg

City Avg: 10.0 Yrs

State Avg: 21.9 Yrs

Regional Practice Density

2 Specialists

Practicing in Covington, KY (836 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

60.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Swanholm (10 Years) 10 Yrs

Covington Specialty Average (10.0 Years) 10.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	173	149	$301.00	$120.51
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	115	115	$394.00	$155.81
99213 Established patient office or other outpatient visit, typically 15 minutes	69	61	$213.00	$85.40
92134 Imaging of retina	63	57	$94.00	$37.06
92133 Imaging of optic nerve	50	36	$85.00	$32.54
92083 Exam of visual field with extended testing	33	28	$143.00	$57.96
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	21	21	$264.00	$97.28

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	162	142	$180.00	$119.08
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	95	95	$270.00	$155.93
99213 Established patient office or other outpatient visit, typically 15 minutes	78	63	$135.00	$85.01
92134 Imaging of retina	64	59	$94.00	$35.94
92133 Imaging of optic nerve	51	39	$92.00	$32.24
92083 Exam of visual field with extended testing	36	31	$131.00	$55.69
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	25	25	$180.00	$105.56
92250 Photography of the retina	11	11	$128.00	$34.62

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	117	106	$177.13	$119.69
99213 Established patient office or other outpatient visit, typically 15 minutes	79	55	$129.33	$82.22
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	66	66	$267.55	$156.99
92133 Imaging of optic nerve	50	38	$92.00	$32.22
92134 Imaging of retina	46	42	$94.00	$37.54
92083 Exam of visual field with extended testing	38	30	$131.00	$56.42
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	20	20	$175.45	$106.28

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	100	100	$264.00	$156.04
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	55	49	$173.00	$118.79
92134 Imaging of retina	46	44	$94.00	$37.81
99213 Established patient office or other outpatient visit, typically 15 minutes	42	32	$119.00	$86.15
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	24	24	$173.00	$99.40
92136 Measurement of corneal curvature and depth of eye	22	11	$120.00	$39.90
92083 Exam of visual field with extended testing	18	16	$131.00	$55.47
92133 Imaging of optic nerve	17	17	$92.00	$32.04

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	23	18	$85.53	$70.60
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	22	22	$264.00	$135.49
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	20	20	$152.92	$96.45
92134 Imaging of retina	14	13	$94.00	$35.59
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	13	13	$140.23	$95.25

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	16	14	$76.23	$69.72
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$139.54	$101.73

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	34	32	$74.00	$67.83
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	23	22	$110.00	$100.16

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
66984 Removal of cataract with insertion of lens	463	15	$11.63	$4.61
99213 Established patient office or other outpatient visit, typically 15 minutes	25	16	$82.00	$67.08
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	23	22	$119.04	$98.94

Medical Specialties & State Licenses

CMS Verified: 2021-04-19

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License KY 2057DT

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.

Optometrist

NUCC Taxonomy Code: 152W00000X

State License OH OPT.006714

Hospital & Practice Group Affiliations

Summit Medical Group Inc

1500 James Simpson Jr Way, Covington, KY 410110800

Phone: 8596554111

Secondary Practice Locations

105 W 4th St

Cincinnati, OH 452022712

Phone: 5136212445

Practice Associates & Co-Workers

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

40 Associated Practitioners

Kennetra Bradshaw , RD

Dietitian, Registered

NPI 1013420207

Registered Dietitian

Dr. Eugene Burchell , MD

Obstetrics & Gynecology

NPI 1013914381

Doctor of Medicine (M.D.)

Dr. Wael Eid , MD

Internal Medicine - Endocrinology, Diabetes & Metabolism

NPI 1013936517

Doctor of Medicine (M.D.)

Eric Wood , PA-C

Physician Assistant

NPI 1013940956

Physician Assistant (Certified)

Briana Vitucci , RD

Dietitian, Registered

NPI 1053088542

Registered Dietitian

Rae Elizagaray , RD

Dietitian, Registered

NPI 1053847707

Registered Dietitian

Career & Practice History Timeline

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

13 Historical Events

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 19, 2021

Optometrist (License #2057DT in KY)

📍

Updated Practice Location February 23, 2021

Registered at 1500 JAMES SIMPSON JR WAY, COVINGTON, KY 410110801 (Tel: 8596553111)

📍

Updated Business Mailing Address February 23, 2021

Registered at PO BOX 635283, CINCINNATI, OH 452635286 (Tel: 8593445555)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 23, 2021

Optometrist (License #OPT.006714 in OH)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) November 08, 2018

Optometrist (License #2057DT in KY)

📍

Updated Practice Location September 21, 2018

Registered at 2498 DIXIE HWY, FT MITCHELL, KY 41017 (Tel: 8593310431)

📍

Updated Business Mailing Address September 21, 2018

Registered at PO BOX 207170, DALLAS, TX 753207156 (Tel: 6362004393)

✅

NPI Profile Active July 08, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location July 08, 2016

Registered at 1124 S STATE ST, BIG RAPIDS, MI 493072256 (Tel: 2315912020)

📍

Updated Business Mailing Address July 08, 2016

Registered at 1124 S STATE ST, BIG RAPIDS, MI 493072256 (Tel: 2315912020)

👤

Provider Name / Credentials Updated July 08, 2016

Recorded as ANTHONY SWANHOLM, OD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2016

Optometrist (License #4901004994 in MI)

🟢

Initial NPI Registration & Enumeration July 08, 2016

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: 1609228089

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 08, 2016

Last Update: April 19, 2021

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 635283

Cincinnati, OH 452635286

Phone: 8593445555

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.