NPIMap

Organization Active NPI

Sloan Eyecare Center L.L.C

Doing business as Premier Eyecare Associates

  • Optometrist
  • Brookfield, MO
National Provider Identifier
1013051390
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SLOAN EYECARE CENTER L.L.C
Doing business as
Premier Eyecare Associates
Practice address
431 S Main St
Brookfield, MO 64628-2146
Phone
(660) 258-7409
Fax
(660) 258-7842
NPI assigned
Feb 19, 2007
Last updated
Jan 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Duane Thompson, O.D.NPI 1740224724
Title
Owner-Mananaging Memeber
Phone
(660) 646-3937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

431 S Main St
Brookfield, MO 64628-2146

Mailing address

431 S Main St
Brookfield, MO 64628-2146
Phone (660) 258-7409

Other identifiers 1

IdentifierTypeStateIssuer
507600203MedicaidMO

Other names 1

  • Premier Eyecare Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050510000899 MO Part B Supplier - Clinic/Group Practice 6103891825 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
Practice locations: Brookfield, MO; Kirksville, MO
O20100930092543 MO DME Supplier - Physician - OptometristDME Supplier - Optician 6103891825 Practice locations: Brookfield, MO

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Premier Eyecare Associates431 S Main St, Brookfield, MO 64628-2146(660) 258-7409 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 2002

National Provider Directory

National Provider Directory
Tax ID family
Sloan Eyecare Center LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1405 N Jefferson St
Carrollton, MO 64633
Phone (660) 542-1333

1115 Washington St
Chillicothe, MO 64601
Phone (660) 258-7409

1904 N Baltimore St
Kirksville, MO 63501
Phone (660) 665-3564

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642636800000",
    "number": "1013051390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 S MAIN ST",
            "city": "BROOKFIELD",
            "state": "MO",
            "postal_code": "646282146",
            "telephone_number": "660-258-7409",
            "fax_number": "660-258-7842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 S MAIN ST",
            "city": "BROOKFIELD",
            "state": "MO",
            "postal_code": "646282146",
            "telephone_number": "660-258-7409",
            "fax_number": "660-258-7842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLOAN EYECARE CENTER L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "DUANE",
        "authorized_official_title_or_position": "OWNER-MANANAGING MEMEBER",
        "authorized_official_telephone_number": "660-646-3937",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507600203",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Eyecare Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier Eyecare Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brookfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.