Individual provider Active NPI

Scott Michael Ackerman, O.D.

  • Optometrist
  • Garden City, KS
National Provider Identifier
1770749160
Registry record updated Nov 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1799 Issued in KS
Practice address
2508 Caseys Dr
Garden City, KS 67846-3314
Phone
(620) 275-5375
Fax
(620) 275-2036
NPI assigned
Aug 5, 2008
Last updated
Nov 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 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 1799 KS Primary

Addresses

Primary practice location

2508 Caseys Dr
Garden City, KS 67846-3314

Mailing address

802 N Campus Dr
Garden City, KS 67846-6342
Phone (620) 275-5375

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
I20080926000630 KS Practitioner - Optometry 2466529862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Northeastern Ohio University College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

802 N Campus Dr
Garden City, KS 67846-6342
Phone (620) 275-5375

Merit-based Incentive Payment System (MIPS)

Final score
89.99 of 100Reported as group
Quality
79.98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1799KSMDClinical Psychologist

Organizations & group practices 1

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": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1770749160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 N CAMPUS DR",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678466342",
            "telephone_number": "620-275-5375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 CASEYS DR",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678463314",
            "telephone_number": "620-275-5375",
            "fax_number": "620-275-2036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "SCOTT",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-05",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, KS

Sources for this page

Verify at the official NPI Registry.