Individual provider Active NPI

Brandon Ray Fisher, OD

  • Optometrist
  • Wichita, KS
National Provider Identifier
1194835520
Registry record updated May 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1740 Issued in KS
Practice address
746 N Maize Rd
Suite #100
Wichita, KS 67212-4502
Phone
(316) 721-8877
Fax
(316) 721-6762
NPI assigned
Aug 30, 2006
Last updated
May 2, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1740 KS Primary

Addresses

Primary practice location

746 N Maize Rd
Suite #100
Wichita, KS 67212-4502

Mailing address

746 N Maize Rd
Suite #100
Wichita, KS 67212
Phone (316) 721-8877

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
I20060927000540 KS Practitioner - Optometry 8325043201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Child and Family Eyecare PAGroup PAC ID 5991701963, 3 clinicians

Practice addresses (Care Compare)

746 N Maize Rd
Wichita, KS 67212-4570
Phone (316) 721-8877

746 N Maize Rd
Suite 100
Wichita, KS 67212-4571

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Child & Family Eyecare PA Optometrist CurrentSince Jan 1, 2008 Accepting new patients
Kansas Vision Development Center Past Accepting new patients

Locations

746 N Maize Rd
Wichita, KS 67212
Phone (316) 721-8877

746 N Maize Rd
Ste 100
Wichita, KS 67212
Phone (316) 665-7647

Organizations & group practices 2

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335916800000",
    "number": "1194835520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "746 N MAIZE RD",
            "address_2": "SUITE #100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67212",
            "telephone_number": "316-721-8877",
            "fax_number": "316-721-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "746 N MAIZE RD",
            "address_2": "SUITE #100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672124502",
            "telephone_number": "316-721-8877",
            "fax_number": "316-721-6762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "BRANDON",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.