Laura A Branstetter, OD
Individual provider Active NPI Optometrist · Derby, KS
NPI 1366494049 · NPPES record last updated Jan 27, 2010
Key facts
- NPI
- 1366494049
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 1321-3 (KS)
- Practice address
- 1105 N Buckner St
Derby, KS 67037-2719 - Phone
- (316) 788-9290
- Fax
- (316) 788-6157
- NPI assigned
- May 17, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- University of Houston - College of Optometry, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Eye to Eye PA
Practice addresses (Care Compare)
1105 N Buckner St
Derby, KS 67037-2719
Phone (316) 788-9290
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 33 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110216000897 | KS | Practitioner - Optometry | 4183666233 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1321-3 | KS | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eye to Eye PA | Optometrist | Current |
Accepting new patients |
| Eye to Eye PA | Optometrist | Current |
Accepting new patients |
Locations
1105 N Buckner St
Derby, KS 67037
Phone (316) 788-9290
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1321-3 | KS | Yes |
Addresses
Primary practice location
1105 N Buckner St
Derby, KS 67037-2719
Mailing address
1105 N Buckner St
Derby, KS 67037-2719
Phone (316) 788-9290
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100279060A | Medicaid | KS |
Other providers in Derby, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.