Individual provider Active NPI

Ann Marie Sparacino, OD

  • Optometrist
  • Wichita, KS
National Provider Identifier
1962175117
Registry record updated Jul 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2154 Issued in KS
Practice address
746 N Maize Rd
Wichita, KS 67212-4570
Phone
(316) 721-8877
NPI assigned
Jul 25, 2021
Last updated
Jul 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2154 KS Primary

Addresses

Primary practice location

746 N Maize Rd
Wichita, KS 67212-4570

Mailing address

746 N Maize Rd
Wichita, KS 67212-4570

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
I20220309000120 KS Practitioner - Optometry 6406240480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Child and Family Eyecare PAGroup PAC ID 5991701963, 3 clinicians

Practice addresses (Care Compare)

746 N Maize Rd
Wichita, KS 67212-4570
Phone (316) 721-8877

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas Vision Development Center PastSince Nov 24, 2021 Accepting new patients

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": "1627171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627171200000",
    "number": "1962175117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "746 N MAIZE RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672124570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "746 N MAIZE RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672124570",
            "telephone_number": "316-721-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARACINO",
        "first_name": "ANN MARIE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-25",
        "last_updated": "2021-07-25",
        "certification_date": "2021-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "2154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.