DR. KENNETH RICHARD STATSICK O.D.
NPI 1407162043
Optometrist in Goldsboro, NC

Active since August 20, 2010PECOS EnrolledAccepts Medicare Assignment
2803 CASHWELL DR, STE A, GOLDSBORO, NC 27534(919) 778-2015(919) 778-4808 Get Directions Write a Review

NPPES record last updated: July 16, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Oct 18, 2022, Aug 24, 2021, Aug 28, 2018 and 1 more (4 updates tracked since 2016).

About Dr. Kenneth Richard Statsick O.d. NPPES

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

DR. KENNETH RICHARD STATSICK O.D. (NPI 1407162043) is an individual optometrist in Goldsboro, North Carolina, licensed in North Carolina (2303) and active in the NPI registry since August 2010. He is enrolled in Medicare PECOS and is a graduate of Nova Southeastern Univ College Of Dental Medicine (2010).

NPPES Registry Identity

NPI1407162043
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. KENNETH RICHARD STATSICKCredential: O.D.
Location Address2803 CASHWELL DR, STE AGoldsboro, NC 27534-4301
Mailing Address2803 Cashwell Dr, Ste AGoldsboro, NC 27534-4301 · (919) 778-2015 · Fax (919) 778-4808
Fax(919) 778-4808
Sole ProprietorYes
Medical School CMSNova Southeastern Univ College Of Dental MedicineGraduated 2010
Enumeration DateAugust 20, 2010
Last NPPES UpdateJuly 16, 20254 updates tracked since enumeration
NPPES CertifiedJuly 16, 2025
NPI 1407162043 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Licenses Licensed in NC · 2303 Licensed in FL · OPC 4549
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.

2803 CASHWELL DR, Goldsboro, NC 27534

Other Identifiers 4

OtherC374NC · Medicare Ptan
Other12143984NC · Caqh
Other5922830NC · Medicaid Pin
Other5922830NC · Medicaid Ptan

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Kenneth Richard Statsick O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID547386492
PECOS Enrollment IDI20130715000560
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
109 services109 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
80 services59 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
35 services35 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
24 services19 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27534 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1407162043, enumerated as an "individual" on August 20, 2010.

The provider is located at 2803 CASHWELL DR STE A GOLDSBORO, NC 27534 and the phone number is (919) 778-2015.

Optometrist with taxonomy code 152W00000X.

The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to verify.