Thomas Gregory Dulos, O.D.
Individual provider Active NPI Optometrist · Ottawa, KS
NPI 1538123765 · NPPES record last updated May 26, 2016
Key facts
- NPI
- 1538123765
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- KS 1167-3 (KS)
- Practice address
- 1302 S Main St
Ottawa, KS 66067-3527 - Phone
- (785) 242-3707
- NPI assigned
- Apr 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- University Alabama Birmingham - School of Optometry, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1302 S Main St
Suite 7
Ottawa, KS 66067-3533
Phone (785) 242-3707
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050328000916 | KS | Practitioner - Optometry | 5092761577 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KS 1167-3 | KS | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | KS 1167-3 | KS | Yes |
Addresses
Primary practice location
1302 S Main St
Ottawa, KS 66067-3527
Mailing address
1302 S Main St
Ottawa, KS 66067-3527
Phone (785) 242-3707
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100217840B | Medicaid | KS |
Other providers in Ottawa, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 26, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.