Stacey Niehues, OD
Individual provider Active NPI Optometrist · Holton, KS
NPI 1154851483 · NPPES record last updated Dec 12, 2018
Key facts
- NPI
- 1154851483
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2058 (KS)
- Practice address
- 121 W 4TH St # at
Holton, KS 66436-1701 - Phone
- (785) 364-5000
- NPI assigned
- Jun 19, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Southern College of Optometry, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Gallagher Eye Care of Holton
Practice addresses (Care Compare)
121 W 4TH St
Holton, KS 66436-1701
Phone (785) 364-5000
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 21 |
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 |
|---|---|---|---|---|
| I20170629002455 | KS | Practitioner - Optometry | 8123397437 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gallagher Eye Care of Holton | Optometrist | Current |
Accepting new patients |
| Kresie & Penzler, M.D.'S PA | Past |
Accepting new patients |
Locations
121 W 4th St
Holton, KS 66436
Phone (785) 364-4183
Interoperability endpoints
- dr.stacey@direct.revolutionehr.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2058 | KS | Yes |
Addresses
Primary practice location
121 W 4TH St # at
Holton, KS 66436-1701
Mailing address
121 W 4TH St # at
Holton, KS 66436-1701
Other providers in Holton, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2018. 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.