DR. DIRK A DITTEMORE (O.D.) – Optometrist, NPI 1538240791

DR. DIRK A DITTEMORE (O.D.) is a healthcare provider. based in Fort leavenworth, Kansas. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 1348 (KS). The NPI Number for DR. DIRK A DITTEMORE (O.D.) is 1538240791

Main info

Male
36 Years Of Experience
Accepts Medicare Assignment
Name
DR. DIRK A DITTEMORE (O.D.)
NPI
1538240791
Phone
(913) 684-6750
Address
550 Pope Ave
Enumeration Date
17 October 2006
Last Update Date
20 May 2025

Doctor Profile

Medical School Name
SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
Secondary Phone
7852235777
Graduation Year
1990 (36 years ago)
PAC ID
2466349618
Group Practice PAC ID
2062494420
Professional Enrollment ID
I20250530001860
Address ID
KS664413230JU1025XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

532 OPTOMETRY in KS

Provider Addresses for DR. DIRK A DITTEMORE (O.D.)

  • 550 Pope Ave

    Optometry Clinic

    Fort Leavenworth, KS 660272332

    Phone: (913) 684-6750

    Type: Location

  • Munson Army Health Center, 550, Pope Avenue, Fort Leavenworth, Leavenworth, Leavenworth County, Kansas, 66027, United States

    OPTOMETRY CLINIC

    FORT LEAVENWORTH, KS 660272332

    Phone: (913) 684-6750

    Type: Location

  • 1025 W 6TH ST

    JUNCTION CITY, KS 664413230

    Phone: (852) 235-7777

    Fax: (785) 223-0257

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-05-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250530001860IOptometryKSTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 66027)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2062494420View full group profile
NameSpecialtyState
O P T O M E T R YKS
O P T O M E T R YKS
O P T O M E T R YKS
O P T O M E T R YKS
O P T O M E T R YKS
O P T O M E T R YMO
-KS
O P T O M E T R YTX
O P T O M E T R YKS
O P T O M E T R YWA

Reviews

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Frequently asked questions

What is DR. DIRK A DITTEMORE (O.D.)'s NPI number?
DR. DIRK A DITTEMORE (O.D.)'s NPI is 1538240791 — the number used across U.S. healthcare to identify this provider.
Would DR. DIRK A DITTEMORE (O.D.) appear as active to a payer?
You can treat DR. DIRK A DITTEMORE (O.D.) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to DR. DIRK A DITTEMORE (O.D.)?
DR. DIRK A DITTEMORE (O.D.)'s specialty line reads Optometrist. Clinical services aligned with this taxonomy classification.
What locale is associated with DR. DIRK A DITTEMORE (O.D.)?
Directory geography for DR. DIRK A DITTEMORE (O.D.) centers on Fort Leavenworth, Kansas.
Can I trust this NPI listing for DR. DIRK A DITTEMORE (O.D.)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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