Kenneth Richard Hansen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

01592 Issued in IA

Practice address

311 N Ankeny Blvd
Ankeny, IA 50023-1711

Phone

(515) 964-1671

Fax

(515) 964-1714

NPI assigned

Jun 17, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in IA

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

University of Houston - College of Optometry, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pietig Family Eyecare PLLC 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Pietig Family Eyecare PLLC

  • Optometrist
  • Ankeny, IA
  • NPI 1811449978

  IA

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360022400000",
    "number": "1295730992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 N ANKENY BLVD",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500231711",
            "telephone_number": "515-964-1671",
            "fax_number": "515-964-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N ANKENY BLVD",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500231711",
            "telephone_number": "515-964-1671",
            "fax_number": "515-964-1714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "KENNETH",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2013-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "01592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "14296",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE II",
            "identifier": "1306056510",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1142968",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "204163573",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "5648350001",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "DE6338",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valerie Hanken, PHARM.D.
• Terri Ann Hannan, PA-C
• Darya Ann Hansen, ARNP
• Emily Nichole Hansen, PMHNP-BC,ARNP, FNP-C
• Julia Elizabeth Hansen, PT, DPT
• Shelley Marie Hansen, OTR
• Harbor of Hope LLC
• Peter Harder, ATC
• Tanya Jane Hargrave-Klein, REGISTERED DIETITIAN
• Kristy Lyn Harken, DPT

• All providers in Ankeny, IA
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; 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.