1. Home
  2. Directory
  3. Kansas
  4. Derby
  5. Optometrist
  6. NPI Profile

DERBY EYECARE LLC
NPI 1134500101
Optometrist in Derby, KS

Active since June 15, 2015
1626 E MADISON AVE, DERBY, KS 67037(316) 640-4180 Get Directions Write a Review

NPPES record last updated: August 4, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Derby Eyecare Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DERBY EYECARE LLC (NPI 1134500101) is a healthcare organization registered as an optometrist in Derby, Kansas and active in the NPI registry since June 2015. The organization lists Logan Kale Banister, Owner/managing Member, as its authorized official.

NPPES Registry Identity

NPI1134500101
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameDERBY EYECARE LLC
Location Address1626 E MADISON AVEDerby, KS 67037-2076
Mailing Address1626 E Madison AveDerby, KS 67037-2076 · (316) 640-4180
Phone(316) 640-4180
Organization SubpartNo
Authorized OfficialLogan Kale BanisterOwner/managing Member · (316) 640-4180
Enumeration DateJune 15, 2015
Last NPPES UpdateAugust 4, 2015
✔ NPI 1134500101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in KS · 1856
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
1626 E MADISON AVE, Derby, KS 67037
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Kansas, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Derby Eyecare Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Derby Eyecare LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Logan Banister, O.D.
Optometry
NPI 1154551828
1626 E MADISON AVE
Derby, KS 67037
(316) 788-1535
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Medical Equipment Supplier Medicare DMEPOS 2

Medicare supplier enrollment and the product categories Derby Eyecare LLC carries, from the Medicare DMEPOS supplier directory.

Derby Eyecare LLC

DMEPOS supplier · Derby, KS
✔

Accepts Medicare assignment

Derby Eyecare LLC agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20482997
Medicare Participant SinceJuly 1, 2015
Supplier Location1626 E Madison AveDerby, KS 67037
Phone(316) 788-1535
Supplier Specialties
Optometrist

Medicare Product Categories

Prosthetic Lenses: Conventional Eyeglasses
Conventional Eyeglasses
Prosthetic Lenses: Conventional Contact Lenses
Conventional Contact Lenses
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derby Eyecare LLC's NPI number?

The NPI number for Derby Eyecare LLC is 1134500101. It was assigned to this organization in the NPPES registry on June 15, 2015.

Where is Derby Eyecare LLC located?

Derby Eyecare LLC is located at 1626 E Madison Ave, Derby, KS 67037. The listed phone number is (316) 640-4180.

What is Derby Eyecare LLC's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Derby Eyecare LLC enrolled in Medicare?

Yes. Derby Eyecare LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Derby Eyecare LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Derby Eyecare LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Derby Eyecare LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Derby Eyecare LLC accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

What insurance does Derby Eyecare LLC accept?

Health plans from Blue Cross and Blue Shield of Kansas, Inc. list Derby Eyecare LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Derby Eyecare LLC was last updated on August 4, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.