Individual provider Active NPI

Samantha Rau, OD

  • Optometrist
  • Kansas City, KS
National Provider Identifier
1295576874
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2024019848 Issued in MO
Practice address
11010 Haskell Ave
Kansas City, KS 66109-8500
Phone
(816) 478-1230
NPI assigned
Jun 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2024019848 MO Primary

Addresses

Primary practice location

11010 Haskell Ave
Kansas City, KS 66109-8500

Mailing address

7218 Nieman Rd
Shawnee, KS 66203-4460
Phone (316) 712-1647

Other names 1

  • Samantha White Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 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
I20240823003867 MO Practitioner - Optometry 9739628538 Reassigns benefits to 1 organization
I20240823003938 KS Practitioner - Optometry 9739628538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care LLCGroup PAC ID 4385544600, shared by 2 NPIs, 49 clinicians

Practice addresses (Care Compare)

11010 Haskell Ave
Kansas City, KS 66109-8500
Phone (816) 478-1230

9401 N Oak Trfy
Suite 200
Kansas City, MO 64155-3393
Phone (816) 478-1230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2024019848MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care, LLC Optometrist CurrentSince Jul 13, 2024 Accepting new patients
Eye Care LLC Optometrist CurrentSince Jun 16, 2024 Accepting new patients
Eye Care, LLC Optometrist CurrentSince Jun 16, 2024 Accepting new patients
Eye Care, LLC Optometrist Current Accepting new patients

Locations

11010 Haskell Ave
Kansas City, KS 66109

11500 Granada St
Leawood, KS 66211
Phone (816) 350-6902

4741 S Cochise Dr
Independence, MO 64055
Phone (816) 542-2849

9401 N Oak Trfy
Ste 200
Kansas City, MO 64155
Phone (816) 296-9391

Interoperability endpoints

  • Direct secure messaging: samantha.rauod.p1@direct.dvc.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1295576874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7218 NIEMAN RD",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662034460",
            "telephone_number": "316-712-1647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11010 HASKELL AVE",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661098500",
            "telephone_number": "816-478-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAU",
        "first_name": "SAMANTHA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2024019848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "WHITE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.