Scott Michael Carpenter, O.D.
Individual provider Active NPI Optometrist · Ft Riley, KS
NPI 1114920949 · NPPES record last updated Dec 22, 2021
Key facts
- NPI
- 1114920949
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 1256-2 (KS)
- Practice address
- 650 Huebner Rd
Ft Riley, KS 66442-4030 - Phone
- (785) 239-7151
- NPI assigned
- May 24, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Southern College of Optometry, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ryan J Kueker OD PA
Practice addresses (Care Compare)
631 Lincoln Ave
Wamego, KS 66547-1635
Phone (785) 456-2235
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051027000992 | KS | Practitioner - Optometry | 8325014681 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1256-2 | KS | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ryan J. Kueker, OD, PA | Optometrist | Current |
Accepting new patients |
| Sabates Eye Centers, PA | Past | Accepting new patients |
Locations
8200 Southport Dr
Ste 108
Manhattan, KS 66502
Phone (785) 775-1514
520 Main St
Seneca, KS 66538
Phone (785) 456-2236
631 Lincoln Ave
Wamego, KS 66547
Phone (785) 456-2235
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1256-2 | KS | Yes |
Addresses
Primary practice location
650 Huebner Rd
Ft Riley, KS 66442-4030
Mailing address
650 Huebner Rd
Ft Riley, KS 66442-4030
Phone (785) 239-7951
Other providers in Ft Riley, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.