Individual provider Active NPI

Brian W. Buell, O.D.

  • Optometrist
  • Fayetteville, AR
National Provider Identifier
1043355506
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
AR2213 Issued in AR
Practice address
4083 N Shiloh Dr
Suite One
Fayetteville, AR 72703-5300
Phone
(479) 521-7774
Fax
(479) 521-4928
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X AR2213 AR Primary

Addresses

Primary practice location

4083 N Shiloh Dr
Suite One
Fayetteville, AR 72703-5300

Mailing address

4083 N Shiloh Dr
Suite One
Fayetteville, AR 72703-5300
Phone (479) 521-7774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120221000932 AR Practitioner - Optometry 6204943301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4083 N Shiloh Dr
Suite 1
Fayetteville, AR 72703-5201
Phone (479) 521-7774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2213LAMDClinical Social Worker
AR2213ARMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Brian W Buell Eye Care PA CurrentSince Jan 1, 1978 Accepting new patients

Locations

4083 N Shiloh Dr
Fayetteville, AR 72703

4083 N Shiloh Dr
Ste 1
Fayetteville, AR 72703
Phone (479) 521-7774

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043355506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4083 N SHILOH DR",
            "address_2": "SUITE ONE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035300",
            "telephone_number": "479-521-7774",
            "fax_number": "479-521-4928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4083 N SHILOH DR",
            "address_2": "SUITE ONE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035300",
            "telephone_number": "479-521-7774",
            "fax_number": "479-521-4928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUELL",
        "first_name": "BRIAN",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "AR2213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.