Individual provider Active NPI

Nicole J Wainwright, O.D.

  • Optometrist
  • Wamego, KS
National Provider Identifier
1689920480
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1930 Issued in KS
Practice address
631 Lincoln Ave
Wamego, KS 66547
Phone
(785) 456-2236
Fax
(785) 456-2570
NPI assigned
Jul 30, 2012
Last updated
Sep 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 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 1930 KS Primary

Addresses

Primary practice location

631 Lincoln Ave
Wamego, KS 66547

Mailing address

631 Lincoln St
Wamego, KS 66547-1635
Phone (785) 456-2236

Other practice location 1

101 Bluemont Ave Ste C
Manhattan, KS 66502-5093
Phone (785) 593-8019

Other names 1

  • Nicole J Trabuc Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20121113000743 KS Practitioner - Optometry 1254582018 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wainwright Eye Care PAGroup PAC ID 3678725132, 3 clinicians

Practice addresses (Care Compare)

2012 Vanesta PL
Suite 210
Manhattan, KS 66503-4101
Phone (785) 539-8019

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan J. Kueker, OD, PA Optometrist CurrentSince Oct 17, 2012 Accepting new patients
Dr. Verne E Claussen Jr PA Optometrist Past Accepting new patients

Locations

520 Main St
Seneca, KS 66538
Phone (785) 456-2236

631 Lincoln Ave
Wamego, KS 66547
Phone (785) 456-2235

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": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1689920480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 LINCOLN ST",
            "city": "WAMEGO",
            "state": "KS",
            "postal_code": "665471635",
            "telephone_number": "785-456-2236",
            "fax_number": "785-456-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 LINCOLN AVE",
            "city": "WAMEGO",
            "state": "KS",
            "postal_code": "66547",
            "telephone_number": "785-456-2236",
            "fax_number": "785-456-2570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Bluemont Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Manhattan",
            "state": "KS",
            "postal_code": "665025093",
            "country_code": "US",
            "telephone_number": "785-593-8019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAINWRIGHT",
        "first_name": "NICOLE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-30",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "TRABUC",
            "middle_name": "J",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wamego, KS

Sources for this page

Verify at the official NPI Registry.