Individual provider Active NPI

Russell W Hart, O.D.

  • Optometrist
  • Fort Riley, KS
National Provider Identifier
1851386379
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1396-3 Issued in KS
Practice address
8072 Normandy Dr
Fort Riley, KS 66442-7069
Phone
(785) 240-5516
Fax
(785) 239-4065
NPI assigned
Sep 12, 2005
Last updated
Sep 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1396-3 KS Primary

Addresses

Primary practice location

8072 Normandy Dr
Fort Riley, KS 66442-7069

Mailing address

650 Huebner Rd
Fort Riley, KS 66442-4030
Phone (785) 240-5517

Other identifiers 2

IdentifierTypeStateIssuer
651142OtherKSBCBS
100219860EMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1396-3KSMDOptometrist
2037TNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Russell W. Hart, OD Optometrist PastSince Jan 1, 1990 Accepting new patients
Mark Bettencourt, O.D. PC Optometrist PastSince Jun 30, 2015 Accepting new patients
Kyler Knobbe, OD, LLC Optometrist PastSince Aug 1, 2016 Accepting new patients

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": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1851386379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 HUEBNER RD",
            "city": "FORT RILEY",
            "state": "KS",
            "postal_code": "664424030",
            "telephone_number": "785-240-5517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8072 NORMANDY DR",
            "city": "FORT RILEY",
            "state": "KS",
            "postal_code": "664427069",
            "telephone_number": "785-240-5516",
            "fax_number": "785-239-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "RUSSELL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1396-3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "651142",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100219860E",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Riley, KS

Sources for this page

Verify at the official NPI Registry.