Organization Active NPI

Ryan J. Kueker, OD, PA

  • Optometrist
  • Wamego, KS
National Provider Identifier
1033201876
Registry record updated Nov 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1718 Issued in KS
Legal business name
RYAN J. KUEKER, OD, PA
Practice address
631 Lincoln St
Wamego, KS 66547-1635
Phone
(785) 456-2236
Fax
(785) 456-2570
NPI assigned
Sep 29, 2006
Last updated
Nov 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Ryan Jennings Kueker, ODNPI 1154423242
Title
President/Owner
Phone
(785) 456-2236

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1718 KS Primary

Addresses

Primary practice location

631 Lincoln St
Wamego, KS 66547-1635

Mailing address

PO Box 27
Wamego, KS 66547-0027
Phone (785) 456-2236

Other identifiers 1

IdentifierTypeStateIssuer
200357750AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051004000313 KS Part B Supplier - Clinic/Group Practice 7810922390 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
Practice locations: Onaga, KS; Wamego, KS; Seneca, KS; Saint Marys, KS; Manhattan, KS

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

8200 Southport Dr
Ste 108
Manhattan, KS 66502
Phone (785) 775-1514

525 W Bertrand Ave
Saint Marys, KS 66536
Phone (785) 437-2978

33 S 4th St
Ste B
Seneca, KS 66538
Phone (785) 456-2236

520 Main St
Seneca, KS 66538
Phone (785) 456-2236

631 Lincoln Ave
Wamego, KS 66547
Phone (785) 456-2235

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227484800000",
    "number": "1033201876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27",
            "city": "WAMEGO",
            "state": "KS",
            "postal_code": "665470027",
            "telephone_number": "785-456-2236",
            "fax_number": "785-456-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 LINCOLN ST",
            "city": "WAMEGO",
            "state": "KS",
            "postal_code": "665471635",
            "telephone_number": "785-456-2236",
            "fax_number": "785-456-2570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN J. KUEKER, OD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2008-11-24",
        "status": "A",
        "authorized_official_last_name": "KUEKER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "JENNINGS",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "785-456-2236",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200357750A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wamego, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.