Individual provider Active NPI

Richard E Schuck, O.D.

  • Optometrist
  • Fort Thomas, KY
National Provider Identifier
1528093390
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0772DT Issued in KY
Practice address
92 Alexandria Pike
Fort Thomas, KY 41075-1729
Phone
(859) 781-2000
Fax
(859) 781-8122
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0772DT KY Primary

Addresses

Primary practice location

92 Alexandria Pike
Fort Thomas, KY 41075-1729

Mailing address

92 Alexandria Pike
Fort Thomas, KY 41075-1729
Phone (859) 781-2000

Other identifiers 1

IdentifierTypeStateIssuer
77007722MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20120121000028 KY Practitioner - Optometry 1759484157 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sunderman Dowdall Optometrist CurrentSince Feb 1, 2022 Accepting new patients

Locations

92 Alexandria Pike
Fort Thomas, KY 41075
Phone (859) 441-3400

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1528093390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 ALEXANDRIA PIKE",
            "city": "FORT THOMAS",
            "state": "KY",
            "postal_code": "410751729",
            "telephone_number": "859-781-2000",
            "fax_number": "859-781-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 ALEXANDRIA PIKE",
            "city": "FORT THOMAS",
            "state": "KY",
            "postal_code": "410751729",
            "telephone_number": "859-781-2000",
            "fax_number": "859-781-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUCK",
        "first_name": "RICHARD",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "0772DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77007722",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Thomas, KY

Sources for this page

Verify at the official NPI Registry.