Blake J. Hoffman, OD, PA
Organization Active NPI Optometrist · Belleville, KS
NPI 1003192162 · NPPES record last updated Nov 2, 2011
Key facts
- NPI
- 1003192162
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 1870 (KS)
- Legal business name
- BLAKE J. HOFFMAN, OD, PA
- Practice address
- 2204 M St
Belleville, KS 66935-2244 - Phone
- (785) 527-2965
- NPI assigned
- Nov 2, 2011
- Organization subpart
- No
Authorized official
- Name
- Dr. Blake Hoffman, O.D.
- Title
- President
- Phone
- (785) 527-2965
Practitioners 2
-
Blake Hoffman, O.D.
-
Michael J Keefer, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120224000095 | KS | Part B Supplier - Clinic/Group Practice | 8729246574 |
Receives reassigned benefits from 1 practitioner Practice locations: Belleville, KS |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 1870 | KS | Yes |
Addresses
Primary practice location
2204 M St
Belleville, KS 66935-2244
Mailing address
PO Box 130
Belleville, KS 66935-0130
Phone (785) 527-2965
Other providers in Belleville, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.