Individual provider Active NPI

Ronald Stephen Keck, O.D.

  • Optometrist
  • Hanford, CA
National Provider Identifier
1104812346
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT10114T Issued in CA
Practice address
1395 W Lacey Blvd
Hanford, CA 93230-5904
Phone
(559) 585-3937
Fax
(559) 582-3645
NPI assigned
Sep 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT10114T CA Primary

Addresses

Primary practice location

1395 W Lacey Blvd
Hanford, CA 93230-5904

Mailing address

1395 W Lacey Blvd
Hanford, CA 93230-5904
Phone (559) 585-3937

Other identifiers 1

IdentifierTypeStateIssuer
GSD004060MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080605000650 CA Practitioner - Optometry 1850461666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1993
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1395 W Lacey Blvd
Hanford, CA 93230-5904

1395 W Lacey Boulevard
Hanford, CA 93230-5904

Merit-based Incentive Payment System (MIPS)

Final score
80.4 of 100Reported as group
Quality
68.66
Improvement activities
40
Cost
76.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT10114TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Eye Surgeons, a California Professional Medical Corporation Optometrist CurrentSince Jun 13, 2023 Accepting new patients
Kings Eye Center Medical Group, Inc. Current Accepting new patients
Pacific Eye Surgeons, a California Professional Medical Corporation CurrentSince Jun 13, 2023 Accepting new patients

Locations

1395 W Lacey Blvd
Hanford, CA 93230
Phone (559) 585-3937

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300752000000",
    "number": "1104812346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 W LACEY BLVD",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932305904",
            "telephone_number": "559-585-3937",
            "fax_number": "559-582-3645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 W LACEY BLVD",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932305904",
            "telephone_number": "559-585-3937",
            "fax_number": "559-582-3645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KECK",
        "first_name": "RONALD",
        "middle_name": "STEPHEN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2011-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT10114T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD004060",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanford, CA

Sources for this page

Verify at the official NPI Registry.