Douglas Alan Donnelly, O.D.
Individual provider Active NPI Optometrist · Iola, KS
NPI 1912972308 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1912972308
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 1277 (KS)
- Practice address
- 424 N Washington Ave
Iola, KS 66749-2353 - Phone
- (620) 365-2108
- Fax
- (620) 365-2522
- NPI assigned
- Feb 21, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- University of Houston - College of Optometry, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Iola Vision Source, LLC
Practice addresses (Care Compare)
216 N Jefferson Ave
Iola, KS 66749-2943
Phone (620) 365-2108
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100517000189 | KS | Practitioner - Optometry | 8022146729 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iola Vision Source, LLC | Optometrist | Current |
Accepting new patients |
| Reynolds & Anliker Eye Physicians & Surgeons LLC | Past | Accepting new patients |
Locations
216 N Jefferson Ave
Iola, KS 66749
Phone (620) 365-2108
424 N Washington Ave
Iola, KS 66749
Phone (620) 365-2108
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1277 | KS | Yes |
Addresses
Primary practice location
424 N Washington Ave
Iola, KS 66749-2353
Mailing address
PO Box 847
424 N Washington
Iola, KS 66749-0847
Phone (620) 365-2108
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00094712 | Other | KS | RAILROAD MEDICARE |
| 658080 | Other | KS | FIRSTGUARD |
| 100218530B | Medicaid | KS |
Other providers in Iola, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.