Individual provider Active NPI

Ryan Michael Dugan, O.D.

  • Optometrist
  • Andale, KS
National Provider Identifier
1104177104
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1939 Issued in KS
Practice address
228 Andale Rd
Andale, KS 67001-9656
Phone
(316) 393-8872
NPI assigned
Oct 1, 2012
Last updated
Oct 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1939 KS Primary

Addresses

Primary practice location

228 Andale Rd
Andale, KS 67001-9656

Mailing address

228 N Andale Rd
Andale, KS 67001-9656
Phone (316) 444-2000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130211000101 KS Practitioner - Optometry 1456505940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

228 Andale Rd
Andale, KS 67001-9656
Phone (316) 444-2000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1939KSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan Dugan Eye Care, LLC Optometrist CurrentSince Jul 21, 2012 Accepting new patients

Locations

228 Andale Rd
Andale, KS 67001
Phone (316) 444-2000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1104177104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 N ANDALE RD",
            "city": "ANDALE",
            "state": "KS",
            "postal_code": "670019656",
            "telephone_number": "316-444-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 ANDALE RD",
            "city": "ANDALE",
            "state": "KS",
            "postal_code": "670019656",
            "telephone_number": "316-393-8872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGAN",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-01",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andale, KS

Sources for this page

Verify at the official NPI Registry.