Individual provider Active NPI

Ashtin Marie Heath Powell, OD

  • Optometrist
  • Derby, KS
National Provider Identifier
1760373955
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2251 Issued in KS
Practice address
1105 N Buckner St
Derby, KS 67037-2719
Phone
(316) 788-9290
NPI assigned
Jul 14, 2025
Last updated
Aug 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2251 KS Primary

Addresses

Primary practice location

1105 N Buckner St
Derby, KS 67037-2719

Mailing address

1105 N Buckner St # B
Derby, KS 67037-2719
Phone (316) 788-9290

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
I20250725000940 KS Practitioner - Optometry 4587171517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye to Eye PAGroup PAC ID 2466494513, 3 clinicians

Practice addresses (Care Compare)

1105 N Buckner St
Derby, KS 67037-2719
Phone (316) 788-9290

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2251KSMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye to Eye PA Optometrist CurrentSince Jul 21, 2025 Accepting new patients
Eye to Eye PA Optometrist CurrentSince Jul 21, 2025 Accepting new patients

Locations

1105 N Buckner St
Derby, KS 67037
Phone (316) 788-9290

1105 N Buckner St
#B
Derby, KS 67037

Organizations & group practices 2

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": "1752451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1760373955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 N BUCKNER ST # B",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670372719",
            "telephone_number": "316-788-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 N BUCKNER ST",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670372719",
            "telephone_number": "316-788-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "ASHTIN",
        "middle_name": "MARIE HEATH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "2251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, KS

Sources for this page

Verify at the official NPI Registry.