Kenneth Alan Rousselo, OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1466 Issued in NC

Practice address

258 Towne Village Dr
Cary, NC 27513-8910

Phone

(919) 467-4657

Fax

(919) 462-0199

NPI assigned

Mar 6, 2006

Last updated

Mar 15, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Optometry

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Preston Optometry Center, PA

  • Optometrist
  • Cary, NC
  • NPI 1134441066
  Medicare reassignment Authorized official
• Canting Optometry, PLLC

  • Optometrist
  • Cary, NC
  • NPI 1699791228
  NPD (past)
• Healthsource of Cary, PLLC

  • Chiropractor
  • Cary, NC
  • NPI 1396028437
  NPD (past)

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

{
    "created_epoch": "1141603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458000000000",
    "number": "1578530879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 TOWNE VILLAGE DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138910",
            "telephone_number": "919-467-4657",
            "fax_number": "919-462-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 TOWNE VILLAGE DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138910",
            "telephone_number": "919-467-4657",
            "fax_number": "919-462-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSSELO",
        "first_name": "KENNETH",
        "middle_name": "ALAN",
        "credential": "OD PC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-06",
        "last_updated": "2016-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Robert Rothrock
• Zachary Rothwell, PMHNP
• Diana Grace Rotsko, MS, RD, LDN
• Courtnee A R Roulhac, M.ED., CCC-SLP
• Round the Clock Home Health Services LLC
• Bridget Frances Rowe, LCSW
• Noelle Cassandra Rowe, LCMHCA
• Jennifer Suzanne Rowen, MA, CF-SLP
• Danielle Louise Rowland, D.D.S
• Jennifer Rowland, AU.D.

• Optometrist in Cary, NC
• Providers in Cary, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; 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.