Katelyn Marie Ebberwein, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2146 Issued in KS

Practice address

1223 N Rock Rd BLDG C
Wichita, KS 67206-1277

Phone

(316) 634-2020

NPI assigned

Jul 20, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Katelyn Marie Flood Former name

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lentz Enterprises, LLCGroup PAC ID 9830131861, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lentz Enterprises LLC

  • Optometrist
  • Wichita, KS
  • NPI 1790708873
  Medicare reassignment Care Compare group NPD
• Lentz Enterprises, LLC

  • Optometrist
  • Newton, KS
  • NPI 1790077980
  NPD

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1063085843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 S CHAUTAUQUA AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672112146",
            "telephone_number": "620-210-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 N ROCK RD BLDG C",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672061277",
            "telephone_number": "316-634-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBBERWEIN",
        "first_name": "KATELYN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "2146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "FLOOD",
            "middle_name": "MARIE",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kim L Eastes, D.C.
• Ashley A Eastman, NP
• Eastside Medical Consultants LLC
• Eat Play Communicate, LLC
• Christopher A Ebberwein, PH.D.
• Laurie Ebenkamp, RPT
• Isabelle Eberle, PTA
• Cynthia Marie Ebers, RNFA
• Lowell D Ebersole, D.O.
• Trenton Layne Ebersole, DDS

• Optometrist in Wichita, KS
• Providers in Wichita, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.