Active NPI 1205898145 Individual Practitioner Female Practitioner

Dr. Karen T Fortman , OD

Optometrist • Sidney, OH

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Karen Fortman, OD is a certified Optometrist practicing in Sidney, OH. With approximately 32 years of clinical experience since graduating from Ohio State University - College Of Optometry in 1994, Dr. Fortman delivers high-quality medical care to the local community at 1086 FAIRINGTON DR.

Dr. Fortman is affiliated with Primary Eyecare Associates Inc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, photography of the retina, exam of visual field with extended testing. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1086 Fairington Dr

Sidney, OH 453658913

Telephone 9374929197

Fax 9374921901

Associated Practice Facility / Clinic

🏢 Primary Eyecare Associates Inc Facility NPI 1093927881

Medicare Profile & Education

Medical School

Ohio State University - College Of Optometry

Graduation Year

1994

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Sidney, OH

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

32 Yrs +11.1 yrs vs City Avg

City Avg: 20.9 Yrs

State Avg: 23.4 Yrs

Regional Practice Density

16 Specialists

Practicing in Sidney, OH (2535 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

21.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Fortman (32 Years) 32 Yrs

Sidney Specialty Average (20.9 Years) 20.9 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	469	387	$132.60	$121.11
92250 Photography of the retina	214	208	$80.00	$33.74
99213 Established patient office or other outpatient visit, typically 15 minutes	196	157	$93.87	$85.64
92083 Exam of visual field with extended testing	122	100	$82.00	$58.32
92134 Imaging of retina	66	57	$70.00	$36.50
92133 Imaging of optic nerve	63	61	$70.00	$31.78
92285 Photography of content of eyes	46	41	$49.46	$20.99
92014 Established patient complete exam of visual system	34	34	$124.71	$117.05
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	29	21	$58.00	$53.03
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	15	15	$172.80	$158.59
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$114.73	$105.31

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	409	357	$130.00	$118.75
99213 Established patient office or other outpatient visit, typically 15 minutes	183	146	$92.90	$83.78
92250 Photography of the retina	168	161	$80.00	$33.59
92083 Exam of visual field with extended testing	123	95	$82.00	$56.83
92134 Imaging of retina	86	74	$70.00	$36.37
92133 Imaging of optic nerve	61	54	$70.00	$31.33
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	40	32	$58.00	$52.36
92014 Established patient complete exam of visual system	29	29	$120.00	$115.76
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	26	26	$170.00	$156.53
92020 Examination of cornea and iris using lens device and slit lamp	18	18	$45.00	$25.86
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$114.00	$105.66

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	408	369	$89.00	$86.07
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	327	298	$127.23	$121.71
92250 Photography of the retina	195	189	$80.00	$34.42
92083 Exam of visual field with extended testing	125	112	$82.00	$58.25
92014 Established patient complete exam of visual system	104	104	$119.70	$116.27
92134 Imaging of retina	95	86	$70.00	$37.07
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	85	74	$55.24	$53.46
92133 Imaging of optic nerve	73	72	$70.00	$32.46
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	65	65	$110.23	$106.96
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	44	44	$165.00	$160.27
92004 New patient complete exam of visual system	34	34	$125.00	$122.07
92020 Examination of cornea and iris using lens device and slit lamp	19	16	$45.00	$26.50
76514 Ultrasound scan of cornea to determine thickness	16	16	$25.00	$10.44

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	219	194	$75.83	$75.83
92250 Photography of the retina	191	181	$80.00	$37.38
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	173	168	$111.38	$111.34
92014 Established patient complete exam of visual system	84	84	$120.00	$120.00
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	80	57	$44.27	$44.26
92083 Exam of visual field with extended testing	79	68	$82.00	$60.26
92134 Imaging of retina	50	49	$70.00	$38.46
92004 New patient complete exam of visual system	45	45	$125.00	$125.00
92133 Imaging of optic nerve	35	35	$70.00	$33.69
92020 Examination of cornea and iris using lens device and slit lamp	20	20	$45.00	$26.99
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	19	19	$141.32	$141.29
76514 Ultrasound scan of cornea to determine thickness	17	17	$25.00	$10.71
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$110.00	$109.66

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	124	118	$75.00	$72.98
92014 Established patient complete exam of visual system	121	120	$120.00	$119.88
92250 Photography of the retina	108	103	$80.00	$42.95
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	63	34	$44.00	$43.95
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	18	17	$110.83	$106.09
92083 Exam of visual field with extended testing	17	17	$82.00	$60.35
92134 Imaging of retina	15	15	$70.00	$38.83
92004 New patient complete exam of visual system	14	14	$125.00	$124.90
92133 Imaging of optic nerve	11	11	$70.00	$34.18

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	175	157	$75.00	$71.26
92014 Established patient complete exam of visual system	113	113	$120.00	$118.58
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	80	62	$44.00	$42.97
92250 Photography of the retina	60	59	$80.00	$47.15
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	26	26	$110.00	$104.69
92133 Imaging of optic nerve	25	22	$70.00	$34.18
92083 Exam of visual field with extended testing	22	22	$82.00	$60.71
92004 New patient complete exam of visual system	17	17	$125.00	$123.72

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	156	154	$120.00	$118.67
99213 Established patient office or other outpatient visit, typically 15 minutes	153	138	$75.00	$70.21
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	98	65	$44.42	$41.90
92250 Photography of the retina	68	66	$80.00	$53.70
92004 New patient complete exam of visual system	32	32	$125.00	$123.60
92083 Exam of visual field with extended testing	31	30	$82.00	$60.94
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	28	28	$110.00	$103.71
92133 Imaging of optic nerve	28	26	$70.00	$33.72
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	21	21	$110.00	$104.21
92134 Imaging of retina	12	12	$70.00	$38.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	162	159	$119.88	$114.08
99213 Established patient office or other outpatient visit, typically 15 minutes	109	98	$74.82	$67.79
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	73	44	$43.95	$40.02
92250 Photography of the retina	50	48	$79.94	$59.74
92004 New patient complete exam of visual system	21	21	$125.00	$121.92
92133 Imaging of optic nerve	17	16	$70.00	$33.07
92012 Established patient problem focused exam of visual system	12	11	$84.75	$79.08

Medical Specialties & State Licenses

CMS Verified: 2022-11-18

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License OH 4599

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

0991431 (OH)

Commercial Insurance / Payer ID Dmerc

0176440002 (OH)

Commercial Insurance / Payer ID Dmerc

0176440001 (OH)

Hospital & Practice Group Affiliations

Primary Eyecare Associates Inc

1086 Fairington Dr, Sidney, OH 453658913

Phone: 9374929197

Practice Associates & Co-Workers

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

12 Associated Practitioners

Dr. Eric Beigel , OD

Optometrist

NPI 1053042085

Doctor of Optometry

Dr. Allyson Schmidt , OD

Optometrist

NPI 1053240457

Doctor of Optometry

Dr. Andrew Roy , OD

Optometrist

NPI 1093979916

Doctor of Optometry

Dr. Carter Bensman , OD

Optometrist

NPI 1265163919

Doctor of Optometry

Dr. John Beigel , OD

Optometrist

NPI 1275595621

Doctor of Optometry

Jacob Luthman

Optometrist

NPI 1548731557

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active November 15, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location November 15, 2007

Registered at 1086 FAIRINGTON DR, SIDNEY, OH 453658913 (Tel: 9374929197)

📍

Updated Business Mailing Address November 15, 2007

Registered at 1086 FAIRINGTON DR, SIDNEY, OH 453658913 (Tel: 9374929197)

👤

Provider Name / Credentials Updated November 15, 2007

Recorded as KAREN FORTMAN, O.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) November 15, 2007

Optometrist (License #4599 in OH)

🟢

Initial NPI Registration & Enumeration April 05, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1205898145

Entity Type:

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

Enumeration Date: April 05, 2006

Last Update: November 18, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1086 Fairington Dr

Sidney, OH 453658913

Phone: 9374929197

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.