Individual provider Active NPI

Christopher S Ketcherside, MD

  • Ophthalmology Physician
  • Overland Park, KS
National Provider Identifier
1952523334
Registry record updated Sep 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0433846 Issued in KS
Practice address
7504 Antioch Rd
Overland Park, KS 66204-2622
Phone
(913) 341-3100
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 0433846 KS Primary

Addresses

Primary practice location

7504 Antioch Rd
Overland Park, KS 66204-2622

Mailing address

7504 Antioch Rd
Overland Park, KS 66204-2622
Phone (913) 341-3100

Other identifiers 1

IdentifierTypeStateIssuer
P00732950OtherRAILROAD MEDICARE

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090729000358 KS Practitioner - Ophthalmology 0143396614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Missouri, Columbia School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas City Eye Clinic, P.a.Group PAC ID 0143206102, 9 clinicians

Practice addresses (Care Compare)

7504 Antioch Rd
Overland Park, KS 66204-2622
Phone (913) 341-3100

Merit-based Incentive Payment System (MIPS)

Final score
91.59 of 100Reported as group
Quality
96.44
Improvement activities
40
Cost
76.71

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery602

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0433846KSMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas City Eye Clinic, P.a. Ophthalmology CurrentSince Aug 1, 2009 Accepting new patients
Kansas City Surgery Center, LLC CurrentSince Aug 1, 2009 Accepting new patients

Locations

4061 Indian Creek Pkwy
Ste 310
Overland Park, KS 66207
Phone (913) 341-3100

7504 Antioch Rd
Overland Park, KS 66204
Phone (913) 341-3100

Interoperability endpoints

  • Direct secure messaging: cketcherside@kceyeclinic.direct.eyemdemr.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251763200000",
    "number": "1952523334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7504 ANTIOCH RD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662042622",
            "telephone_number": "913-341-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7504 ANTIOCH RD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662042622",
            "telephone_number": "913-341-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHERSIDE",
        "first_name": "CHRISTOPHER",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2009-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KS",
            "license": "0433846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00732950",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.