Ryan Steve Kucala, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ATI4501 Issued in OR

Practice address

520 NW Lost Springs Ter # Unite203
Portland, OR 97229-6655

Phone

(503) 621-2160

NPI assigned

May 20, 2019

Sex

Male

Sole proprietor

No

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 OR

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1720645302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 NW LOST SPRINGS TER # UNITE203",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972296655",
            "telephone_number": "503-621-2160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 NW LOST SPRINGS TER # UNITE203",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972296655",
            "telephone_number": "503-621-2160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCALA",
        "first_name": "RYAN",
        "middle_name": "STEVE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-20",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "ATI4501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Kubischta
• Forrest Kublick, PSY.D.
• Laura; Kubly
• Natsuki Kubotera, PHARMD
• Cobalt Jace Kubu
• Christina Marie Kucera, MSW, LCSW
• Kevin Edward Kucharski, MD
• Arun Kuchela, MD
• Jarrod S Kucherak, MSN, APRN, FNP-C
• Kamini Kuchinad

• Optometrist in Portland, OR
• Providers in Portland, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.