Mark G. Coble, OD
Individual provider Active NPI Optometrist · Kansas City, KS
NPI 1053307702 · NPPES record last updated Aug 17, 2016
Key facts
- NPI
- 1053307702
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 1098-3 (KS)
- Practice address
- 9501 State Ave
Suite 2
Kansas City, KS 66111-1872 - Phone
- (913) 299-7200
- Fax
- (913) 334-4551
- NPI assigned
- Sep 27, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Southern College of Optometry, 1977
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Coble Eye Associates,P.a.
Practice addresses (Care Compare)
9501 State Ave
Suite 2
Kansas City, KS 66111-1871
Phone (913) 299-7200
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 13 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090924000274 | KS | Practitioner - Optometry | 1254487705 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10982 | KS | MD | Social Worker |
| 1098 | KS | MD | Registered Dietitian |
| 1098-3 | KS | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coble Eye Associates,P.a. | Optometrist | Current |
Accepting new patients |
| Anesthesia Consultants of Pettis County, PC | Past | Accepting new patients |
Locations
2121 Minnesota Ave
Kansas City, KS 66102
Phone (913) 321-4541
9501 State Ave
Ste 2
Kansas City, KS 66111
Phone (913) 299-7200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1098-3 | KS | Yes |
Addresses
Primary practice location
9501 State Ave
Suite 2
Kansas City, KS 66111-1872
Mailing address
9501 State Ave
Ste 2
Kansas City, KS 66111-1871
Phone (913) 299-7200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09088023 | Other | KS | BLUE CROSS BLUE SHIELD OF KANSAS CITY |
Other providers in Kansas City, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2016. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.