Individual provider Active NPI

Ryan H Kays, OD

  • Optometrist
  • Morris, IL
National Provider Identifier
1578640744
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009918 Issued in IL
Practice address
1802 N Division St Ste 205
Morris, IL 60450-3134
Phone
(815) 942-3042
NPI assigned
Nov 1, 2006
Last updated
Mar 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046009918 IL Primary

Addresses

Primary practice location

1802 N Division St Ste 205
Morris, IL 60450-3134

Mailing address

200 W Dakota St
Spring Valley, IL 61362-1906
Phone (815) 663-8281

Other practice location 1

200 W Dakota St
Spring Valley, IL 61362-1906
Phone (815) 663-8281

Other identifiers 3

IdentifierTypeStateIssuer
7215175OtherILBCBS
046009918OtherILDPA/TPA LICENSE
046009918MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20061206000520 IL Practitioner - Optometry 0648279356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 W Dakota St
Spring Valley, IL 61362-1906
Phone (815) 663-8281

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery56

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Blanco Kays Corgiat Eyecare, LLC Optometrist CurrentSince Jan 1, 2012 Accepting new patients
Blanco Kays Corgiat Eyecare, LLC Optometrist CurrentSince Jan 1, 2012 Accepting new patients
J a K Enterprises Inc Optometrist Past Accepting new patients

Locations

1802 N Division St
Ste 205
Morris, IL 60450
Phone (815) 941-6988

200 W Dakota St
Spring Valley, IL 61362
Phone (815) 663-8281

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1578640744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W DAKOTA ST",
            "city": "SPRING VALLEY",
            "state": "IL",
            "postal_code": "613621906",
            "telephone_number": "815-663-8281",
            "fax_number": "815-663-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 N DIVISION ST STE 205",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604503134",
            "telephone_number": "815-942-3042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Dakota St",
            "address_purpose": "LOCATION",
            "city": "Spring Valley",
            "state": "IL",
            "postal_code": "613621906",
            "country_code": "US",
            "telephone_number": "815-663-8281",
            "fax_number": "815-663-8190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAYS",
        "first_name": "RYAN",
        "middle_name": "H",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "7215175",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPA/TPA LICENSE",
            "identifier": "046009918",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009918",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morris, IL

Sources for this page

Verify at the official NPI Registry.