Individual provider Active NPI

Ryan Jennings Kueker I, O.D.

  • Optometrist
  • Wamego, KS
National Provider Identifier
1154423242
Registry record updated Nov 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1718 Issued in KS
Practice address
631 Lincoln St
Wamego, KS 66547-1635
Phone
(785) 456-2236
Fax
(785) 456-2570
NPI assigned
Sep 1, 2006
Last updated
Nov 24, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1718 KS Primary

Addresses

Primary practice location

631 Lincoln St
Wamego, KS 66547-1635

Mailing address

631 Lincoln St
Wamego, KS 66547-1635
Phone (785) 456-2236

Other identifiers 1

IdentifierTypeStateIssuer
200357750AMedicaidKS

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
I20051005000225 KS Practitioner - Optometry 8325073802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ryan J Kueker OD PAGroup PAC ID 7810922390, 4 clinicians

Practice addresses (Care Compare)

310 Leonard St
Onaga, KS 66521-9484
Phone (785) 889-4387

520 Main St
Seneca, KS 66538-1928
Phone (785) 456-2236

525 W Bertrand Ave
Saint Marys, KS 66536-1618
Phone (785) 437-2978

631 Lincoln Ave
Wamego, KS 66547-1635
Phone (785) 456-2235

8200 S Port Dr
Suite 108
Manhattan, KS 66502-8142
Phone (785) 775-1514

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan J. Kueker, OD, PA Optometrist CurrentSince Aug 1, 2005 Accepting new patients

Locations

520 Main St
Seneca, KS 66538
Phone (785) 456-2236

631 Lincoln Ave
Wamego, KS 66547
Phone (785) 456-2235

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Wamego Health CenterWamego, KS, CCN 171337 Hospital Corporate Director Aug 12, 2022
Wamego Health CenterWamego, KS, CCN 17Z337 Hospital Corporate Director Sep 6, 2022
Wamego Family ClinicWamego, KS, CCN 178510 Rural health clinic Corporate Officer Jul 1, 2021

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227484800000",
    "number": "1154423242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 LINCOLN ST",
            "city": "WAMEGO",
            "state": "KS",
            "postal_code": "665471635",
            "telephone_number": "785-456-2236",
            "fax_number": "785-456-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 LINCOLN ST",
            "city": "WAMEGO",
            "state": "KS",
            "postal_code": "665471635",
            "telephone_number": "785-456-2236",
            "fax_number": "785-456-2570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUEKER",
        "first_name": "RYAN",
        "middle_name": "JENNINGS",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2008-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200357750A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wamego, KS

Sources for this page

Verify at the official NPI Registry.