Individual provider Active NPI

Kristin Kay Maus, O.D.

  • Optometrist
  • Fort Madison, IA
National Provider Identifier
1295714145
Registry record updated Feb 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
02324 Issued in IA
Practice address
619 10TH St
Fort Madison, IA 52627-2831
Phone
(319) 372-5181
Fax
(319) 372-0865
NPI assigned
Jan 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 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 02324 IA Primary

Addresses

Primary practice location

619 10TH St
Fort Madison, IA 52627-2831

Mailing address

619 10TH St
Fort Madison, IA 52627-2831
Phone (319) 372-5181

Other identifiers 1

IdentifierTypeStateIssuer
0474155MedicaidIA

Other names 1

  • Dr. Kristin Kay Cannon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20220927002708 DE Practitioner - Optometry 1153354071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Simon Eye Associates PAGroup PAC ID 4082684089, 35 clinicians

Practice addresses (Care Compare)

5301 Limestone Rd
Suite 128
Wilmington, DE 19808-1253
Phone (302) 239-1933

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02324IAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Simon Eye Associates PA Optometrist CurrentSince Oct 1, 2022 Accepting new patients

Locations

5301 Limestone Rd
Ste 128
Wilmington, DE 19808

912 N Union St
Wilmington, DE 19805
Phone (302) 655-8180

Organizations & group practices 1

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329696000000",
    "number": "1295714145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 10TH ST",
            "city": "FORT MADISON",
            "state": "IA",
            "postal_code": "526272831",
            "telephone_number": "319-372-5181",
            "fax_number": "319-372-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 10TH ST",
            "city": "FORT MADISON",
            "state": "IA",
            "postal_code": "526272831",
            "telephone_number": "319-372-5181",
            "fax_number": "319-372-0865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUS",
        "first_name": "KRISTIN",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2012-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0474155",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "CANNON",
            "middle_name": "KAY",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Madison, IA

Sources for this page

Verify at the official NPI Registry.