Individual provider Active NPI

Kacie Lee Stucke, O.D.

  • Optometrist
  • Mason, OH
National Provider Identifier
1568778702
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5971 Issued in OH
Practice address
218 Reading Rd
Mason, OH 45040-1665
Phone
(513) 398-3886
Fax
(513) 398-9836
NPI assigned
Aug 25, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5971 OH Primary

Addresses

Primary practice location

218 Reading Rd
Mason, OH 45040-1665

Mailing address

218 Reading Rd
Mason, OH 45040-1665
Phone (614) 564-7373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20131022001729 OH Practitioner - Optometry 7911132238 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Mason Vision Center LLCGroup PAC ID 8729367404, 6 clinicians
Lebanon Vision Center LLCGroup PAC ID 8426434390, 4 clinicians

Practice addresses (Care Compare)

218 Reading Rd
Mason, OH 45040-1665
Phone (513) 398-3886

777 Columbus Ave
Lebanon, OH 45036-1682

777 Columbus Ave
Lebanon, OH 45036-1684
Phone (513) 932-3343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5971OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lebanon Vision Center, LLC Optometrist CurrentSince Jul 1, 2022 Accepting new patients
West Milton Vision Center, LLC Optometrist CurrentSince May 1, 2021 Accepting new patients
Springboro Vision, LLC Optometrist CurrentSince Oct 8, 2019 Accepting new patients
Kara S Hampton Optometrist PastSince Oct 8, 2019 Accepting new patients

Locations

777 Columbus Ave
Lebanon, OH 45036
Phone (513) 932-3343

245 N Main St
Ste 300
Springboro, OH 45066
Phone (937) 748-2955

1105 S Miami St
West Milton, OH 45383
Phone (937) 698-5171

Organizations & group practices 5

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": "1282694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1568778702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 READING RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450401665",
            "telephone_number": "614-564-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 READING RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450401665",
            "telephone_number": "513-398-3886",
            "fax_number": "513-398-9836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCKE",
        "first_name": "KACIE",
        "middle_name": "LEE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-25",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

Verify at the official NPI Registry.