NPIMap

Organization Active NPI

Eye Associates of Leawood PA

  • Optometrist
  • Leawood, KS
National Provider Identifier
1043331622
Registry record updated Apr 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYE ASSOCIATES OF LEAWOOD PA
Practice address
15069 Nall Ave
Leawood, KS 66223
Phone
(913) 825-2600
Fax
(913) 339-6417
NPI assigned
Apr 2, 2007
Last updated
Apr 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2009

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

Authorized official

Name
Mr. Vincent A Pennipede, ODNPI 1437218484
Title
Owner
Phone
(913) 339-9090

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
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

15069 Nall Ave
Leawood, KS 66223

Mailing address

10120 W 119TH St
Overland Park, KS 66213
Phone (913) 339-9090

Other identifiers 1

IdentifierTypeStateIssuer
38365011OtherMOBLUE CROSS BLUE SHIELD OF KANSAS CITY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070810000786 KS Part B Supplier - Clinic/Group Practice 8325139926 Receives reassigned benefits from 15 practitioners
Practice locations: Overland Park, KS

National Provider Directory

National Provider Directory

Locations

15069 Nall Ave
Overland Park, KS 66223
Phone (913) 825-2600

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239235200000",
    "number": "1043331622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10120 W 119TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66213",
            "telephone_number": "913-339-9090",
            "fax_number": "913-339-6417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15069 NALL AVE",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "66223",
            "telephone_number": "913-825-2600",
            "fax_number": "913-339-6417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE ASSOCIATES OF LEAWOOD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2009-04-09",
        "status": "A",
        "authorized_official_last_name": "PENNIPEDE",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-339-9090",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF KANSAS CITY",
            "identifier": "38365011",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leawood, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.