Kenneth H Ristau, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2643 Issued in MN

Practice address

1200 Susan Dr
Marshall, MN 56258-2580

Phone

(507) 537-9652

Fax

(507) 537-9646

NPI assigned

May 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shoptikal LLCGroup PAC ID 1456684471, 192 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shoptikal LLC

  • Eyewear Supplier
  • Saint Cloud, MN
  • NPI 1942866371

  Optometrist

  Medicare reassignment Care Compare group NPD
• Shoptikal LLC

  • Eyewear Supplier
  • Winona, MN
  • NPI 1730745100

  Optometrist

  NPD
• Shoptikal LLC

  • Eyewear Supplier
  • Rockford, IL
  • NPI 1467311142

  Optometrist

  NPD
• Shopko Stores, Inc.

  • Eyewear Supplier
  • Green Bay, WI
  • NPI 1649215666
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1235180233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 SUSAN DR",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562582580",
            "telephone_number": "507-537-9652",
            "fax_number": "507-537-9646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SUSAN DR",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562582580",
            "telephone_number": "507-537-9652",
            "fax_number": "507-537-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISTAU",
        "first_name": "KENNETH",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darlyce Rangaard
• Heather Elaine Reber, M.D.
• Reverence for Life and Concern for People Inc
• Molly J Richter, MT-BC
• Abby Ree Ricketts, D.C.
• Erin Roberts, CCC-SLP
• Callie Rodriguez, RD, LRD
• Emilee L Rose
• Laura Rae Roxberg
• Cheryl Lee Rude, R.D.

• Optometrist in Marshall, MN
• Providers in Marshall, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.