Individual provider Active NPI

Debra Kirk, O.D.

  • Optometrist
  • Kansas City, MO
National Provider Identifier
1427050475
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T03278 Issued in MO
Practice address
4620 J C Nichols Pkwy
Ste 421
Kansas City, MO 64112-1624
Phone
(816) 561-0306
Fax
(816) 531-7166
NPI assigned
Jun 2, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T03278 MO Primary
Optometrist 152W00000X 1486-3 KS

Addresses

Primary practice location

4620 J C Nichols Pkwy
Ste 421
Kansas City, MO 64112-1624

Mailing address

4601 W 109TH St
Ste 100
Overland Park, KS 66211-1313
Phone (913) 491-0765

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20120924000779 KS Practitioner - Optometry 7113187584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leawood Family Eye Care PAGroup PAC ID 2860563129, 3 clinicians

Practice addresses (Care Compare)

11305 Ash St
Leawood, KS 66211-1643

11401 Ash St
Leawood, KS 66211-1682
Phone (913) 345-8020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1486KSMDPsychologist
1486-3KSMDOptometrist
T03278MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Leawood Family Eye Care PA Optometrist CurrentSince Jun 16, 2012 Accepting new patients
Michael S Mancina, MD & Associates, PA Past Accepting new patients

Locations

11305 Ash St
Leawood, KS 66211
Phone (913) 345-8020

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1427050475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 W 109TH ST",
            "address_2": "STE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111313",
            "telephone_number": "913-491-0765",
            "fax_number": "913-317-9185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 J C NICHOLS PKWY",
            "address_2": "STE 421",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641121624",
            "telephone_number": "816-561-0306",
            "fax_number": "816-531-7166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "DEBRA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T03278",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1486-3",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.