Kimberly Lynn Lust Rueb, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT-OPT-LIC-2223 Issued in MT

Practice address

1621 Market Place Dr
Great Falls, MT 59404-3480

Phone

(406) 454-2202

Fax

(406) 452-1020

NPI assigned

Jul 11, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Other names 1

• Kimberly Lynn Lust Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA, ID, MT3 enrollments

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 3

Specialty

Optometry

Education

Ohio State University - College of Optometry, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Cataract and Laser Institute Inc PCGroup PAC ID 7517864119, shared by 15 NPIs, 75 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pacific Cataract and Laser Institute Inc PC

  • Ambulatory Surgical Clinic/Center
  • Bellevue, WA
  • NPI 1306013925
  Medicare reassignment NPD
• Pacific Cataract and Laser Institute, Inc., P.C.

  • Ambulatory Surgical Clinic/Center
  • Chehalis, WA
  • NPI 1114978848

  ID, MT

  Medicare reassignment NPD
• Pacific Cataract and Laser Institute Inc PC

  • Ambulatory Surgical Clinic/Center
  • Great Falls, MT
  • NPI 1912174996
  NPD
• Pacific Cataract and Laser Institute Inc PC

  • Ambulatory Surgical Clinic/Center
  • Boise, ID
  • NPI 1275700957
  NPD
• Pacific Cataract and Laser Institute Inc PC

  • Ambulatory Surgical Clinic/Center
  • Chehalis, WA
  • NPI 1487821633
  NPD
• Pacific Cataract and Laser Institute Inc PC

  • Ambulatory Surgical Clinic/Center
  • Vancouver, WA
  • NPI 1659548329
  NPD
• Pacific Cataract and Laser Institute, Inc., P.C.

  • Ophthalmologic Surgery Clinic/Center
  • Auburn, WA
  • NPI 1528814647
  NPD
• Pacific Cataract and Laser Institute, Inc., P.C.

  • Ambulatory Surgical Clinic/Center
  • Kennewick, WA
  • NPI 1619144607
  NPD
• Pacific Cataract and Laser Institute, Inc., P.C.

  • Ambulatory Surgical Clinic/Center
  • Spokane Valley, WA
  • NPI 1831366517
  NPD
• Pacific Cataract and Laser Institute, Inc., P.C.

  • Ambulatory Surgical Clinic/Center
  • Lacey, WA
  • NPI 1215178835
  NPD (past)

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

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1508207176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1506",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985320409",
            "telephone_number": "360-242-3008",
            "fax_number": "360-807-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 MARKET PLACE DR",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594043480",
            "telephone_number": "406-454-2202",
            "fax_number": "406-452-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUST RUEB",
        "first_name": "KIMBERLY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-11",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60373324",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100315",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "OPT-OPT-LIC-2223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508207176",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2038492",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508207176",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508207176",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kimberly.rueb.p1@direct.pcli.nextgenshare.com",
            "affiliation": "N",
            "address_1": "1621 Market Place Dr",
            "city": "Great Falls",
            "state": "MT",
            "country_code": "US",
            "postal_code": "594043480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "LUST",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael E Luckett, M.D.
• Chloe Luke, PTA
• Ashley Lundin
• Lori Luoma
• Ryan Michael Luoma, D.O.
• James Lutz, LPC
• Mira Lutz
• Sally Ann Lydon, CRNP
• Delene R Lynes, OTA
• Christine Lyons

• Optometrist in Great Falls, MT
• Providers in Great Falls, MT by specialty
• Optometrist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.