Individual provider Active NPI

Bret D Wise, O.D.

  • Optometrist
  • Wichita, KS
National Provider Identifier
1457517831
Registry record updated Aug 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1831 Issued in KS
Practice address
321 S Hillside St
Wichita, KS 67211-2130
Phone
(316) 685-1898
Fax
(316) 685-4170
NPI assigned
Aug 5, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1831 KS Primary

Addresses

Primary practice location

321 S Hillside St
Wichita, KS 67211-2130

Mailing address

321 S Hillside
Wichita, KS 67211-2130
Phone (316) 685-1898

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
I20081117000001 KS Practitioner - Optometry 6002976461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care Associates of Wichita, P.a.Group PAC ID 3577615780, 5 clinicians

Practice addresses (Care Compare)

321 S Hillside St
Wichita, KS 67211-2130
Phone (316) 685-1898

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Associates of Wichita, P.a. Optometrist CurrentSince May 11, 2009 Accepting new patients
Toso Family Eye Care Optometrist PastSince Jun 15, 2021 Accepting new patients
Patricia a. Dorsey, O.D., P.a. Optometrist PastSince Mar 24, 1992 Accepting new patients

Locations

3911 N Maize Rd
Maize, KS 67101
Phone (316) 558-3021

321 S Hillside St
Wichita, KS 67211
Phone (316) 685-1898

Organizations & group practices 3

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": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438732800000",
    "number": "1457517831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 S HILLSIDE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672112130",
            "telephone_number": "316-685-1898",
            "fax_number": "316-685-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 S HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672112130",
            "telephone_number": "316-685-1898",
            "fax_number": "316-685-4170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "BRET",
        "middle_name": "D",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-05",
        "last_updated": "2015-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.