Richard E Dean, OD

Individual provider Active NPI Optometrist · Tonganoxie, KS

NPI 1366548828 · NPPES record last updated Oct 21, 2016

Key facts

NPI
1366548828
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
992-6 (KS)
Practice address
103 W 4TH St
Tonganoxie, KS 66086-9770
Phone
(913) 845-2030
Fax
(913) 845-9444
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Optometry
Education
Indiana University - School of Optometry, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

420 E 4TH St
Tonganoxie, KS 66086-9218
Phone (913) 845-2030

PO Box
Suite 970
Tonganoxie, KS 66086-0970

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery31

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) 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 IDStateProvider typePAC IDDetails
I20050330001060 KS Practitioner - Optometry 9133175318 Practice locations: Tonganoxie, KS
O20100930094569 KS DME Supplier - Physician - Optometrist 3971620642 Practice locations: Tonganoxie, KS

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
992-6KSMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Tonganoxie Eye Care LLC Optometrist Past
since Dec 22, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 992-6 KS Yes

Addresses

Primary practice location

103 W 4TH St
Tonganoxie, KS 66086-9770

Mailing address

103 W 4TH St
Tonganoxie, KS 66086-9770
Phone (913) 845-2030

Other identifiers

IdentifierTypeStateIssuer
100090660AMedicaidKS

Other providers in Tonganoxie, KS

All providers in Tonganoxie, KS · Optometrist in Kansas

Sources for this page

Verify at the official NPI Registry.