Individual provider Active NPI

Kenneth Karl Morse, O.D.

  • Optometrist
  • Casper, WY
National Provider Identifier
1477539666
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
259T Issued in WY
Practice address
911 Cy Ave
Casper, WY 82601-4160
Phone
(307) 265-4324
Fax
(307) 234-1203
NPI assigned
Dec 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 259T WY Primary

Addresses

Primary practice location

911 Cy Ave
Casper, WY 82601-4160

Mailing address

911 Cy Ave
Casper, WY 82601-4160
Phone (307) 265-4324

Other identifiers 1

IdentifierTypeStateIssuer
119073300MedicaidWY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20101020000319 WY Practitioner - Optometry 1557343431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

911 Cy Ave
Casper, WY 82601-4160
Phone (307) 265-4324

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
259TWYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wyoming Optical Inc PastSince Aug 8, 2003 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1477539666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 CY AVE",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826014160",
            "telephone_number": "307-265-4324",
            "fax_number": "307-234-1203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 CY AVE",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826014160",
            "telephone_number": "307-265-4324",
            "fax_number": "307-234-1203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORSE",
        "first_name": "KENNETH",
        "middle_name": "KARL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WY",
            "license": "259T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119073300",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

Verify at the official NPI Registry.