Adam J Ketteler, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1218 Issued in NE

Practice address

313 W Pearl St
Atkinson, NE 68713-4958

Phone

(402) 925-2669

Fax

(402) 925-2306

NPI assigned

Jul 19, 2006

Last updated

Dec 21, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE2 enrollments

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 2

Other NPIs on the same Medicare enrollment 1

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

• Adam Ketteler, O.D.

  dba Ketteler Eyecare

  • Eyewear Supplier
  • Atkinson, NE
  • NPI 1710123781

  O20100930031333

  Same enrollment

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Adam Ketteler, O.D.

  dba Ketteler Eyecare

  • Eyewear Supplier
  • Atkinson, NE
  • NPI 1710123781
  Authorized official Same address or phone
• Vision Associates Inc

  dba Pearle Vision

  • Optometrist
  • Lincoln, NE
  • NPI 1447386685
  NPD (past)
• Vision Assoicates Inc

  dba Pearle Vision

  • Optometrist
  • Lincoln, NE
  • NPI 1457487696
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261353600000",
    "number": "1093734154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 995",
            "city": "ATKINSON",
            "state": "NE",
            "postal_code": "687130995",
            "telephone_number": "402-925-2669",
            "fax_number": "402-925-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 W PEARL ST",
            "city": "ATKINSON",
            "state": "NE",
            "postal_code": "687134958",
            "telephone_number": "402-925-2669",
            "fax_number": "402-925-2306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTELER",
        "first_name": "ADAM",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2009-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025583200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Holloway, DDS
• Iadakne Medical
• Tammy Jeffrey
• Kassidy Jean Jelinek
• Brenda Sue Kerkman, RN
• James Francis Kubart
• Pamela Kay Kubart
• Jordan Edward Kunz, MD
• Cindy Laetsch
• Amelia Shane McCumber, PA-C

• Optometrist in Atkinson, NE
• Providers in Atkinson, NE by specialty
• Optometrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2009; 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.