Healthcare Provider Details

I. General information

NPI: 1619150984
Provider Name (Legal Business Name): EYE CARE ASSOCIATES OF MANHATTAN, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 CHARLES PL STE 103
MANHATTAN KS
66502-2868
US

IV. Provider business mailing address

1640 CHARLES PL STE 103
MANHATTAN KS
66502-2868
US

V. Phone/Fax

Practice location:
  • Phone: 785-776-9461
  • Fax: 785-776-9946
Mailing address:
  • Phone: 785-776-9461
  • Fax: 785-776-9946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number1757
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number1776
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1757
License Number StateKS

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier200568820A
Identifier TypeMEDICAID
Identifier StateKS
Identifier Issuer

VIII. Authorized Official

Name: DR. MATTHEW T STANLEY
Title or Position: PRESIDENT
Credential: O.D.
Phone: 785-776-9461