Individual provider Active NPI

Betsy Alyse Koster, O.D.

  • Optometrist
  • Saint Joseph, MO
National Provider Identifier
1174970008
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1667 Issued in NE
Practice address
3702 Frederick Ave
Suite #12
Saint Joseph, MO 64506-3059
Phone
(816) 233-9898
NPI assigned
May 20, 2016
Last updated
Jan 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2016015956 MO
Optometrist 152W00000X 1667 NE Primary

Addresses

Primary practice location

3702 Frederick Ave
Suite #12
Saint Joseph, MO 64506-3059

Mailing address

3702 Frederick Ave Ste 12
Saint Joseph, MO 64506-3084
Phone (816) 233-9898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, NE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211112001587 MO Practitioner - Optometry 3870982879 Reassigns benefits to 1 organization
I20251017000233 NE Practitioner - Optometry 3870982879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

19100 Ridgewood Parkway
BLDG 1 7TH Floor
San Antonio, TX 78259-0001

5436 NW Walden Dr
Kansas City, MO 64151-0001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Visionworks, Inc. Optometrist CurrentSince Jul 24, 2025 Accepting new patients
Visionworks, Inc. Optometrist CurrentSince Aug 13, 2021 Accepting new patients
Visionworks, Inc CurrentSince Aug 13, 2021 Accepting new patients

Locations

8600 Ward Pkwy
Ste 710
Kansas City, MO 64114
Phone (816) 523-8882

7505 Towne Center Pkwy
Ste 101
Papillion, NE 68046
Phone (402) 339-2481

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, 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": "1463702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1174970008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 FREDERICK AVE STE 12",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063084",
            "telephone_number": "816-233-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 FREDERICK AVE",
            "address_2": "SUITE #12",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063059",
            "telephone_number": "816-233-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTER",
        "first_name": "BETSY",
        "middle_name": "ALYSE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-20",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2016015956",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

Verify at the official NPI Registry.