Iowa Eye Prosthetics Inc

Primary specialty

OcularistTaxonomy code 156FX1700X

Legal business name

IOWA EYE PROSTHETICS INC

Practice address

625 First Avenue
Ste 200
Coralville, IA 52241

Phone

(319) 354-3434

Fax

(319) 354-3465

NPI assigned

Jul 12, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David Michael Bulgarelli, BCO FASO BA

Title

President Ocularist

Phone

(319) 354-3434

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Tax ID family

Iowa Eye Prosthetics Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Iowa Eye Prosthetics, Inc.

  • Customized Equipment (DME)
  • Coralville, IA
  • NPI 1205983897
  NPD tax ID

Locations

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063447217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 FIRST AVENUE",
            "address_2": "STE 200",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "52241",
            "telephone_number": "319-354-3434",
            "fax_number": "319-354-3465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 FIRST AVENUE",
            "address_2": "STE 200",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "52241",
            "telephone_number": "319-354-3434",
            "fax_number": "319-354-3465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA EYE PROSTHETICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BULGARELLI",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT OCULARIST",
        "authorized_official_telephone_number": "319-354-3434",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BCO FASO BA"
    },
    "taxonomies": [
        {
            "code": "156FX1700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Ocularist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0128413",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "50796",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KS",
            "identifier": "63648",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "A001983",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "12841",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "40219IO",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Iowa Audiology & Hearing Aid Centers Inc
• Iowa Chiropractic and Performance Center
• Iowa City Plastic Surgery LLC
• Iowa CVS Pharmacy LLC
• Iowa Dental Health Professionals, P.C.
• Iowa Eye Prosthetics, Inc.
• Iowa Medical & Classification Center
• Iowa Medicine LLC
• Iowa Open MRI
• Iowa Pediatric Dental Center

• Technician/Technologist in Coralville, IA
• Providers in Coralville, IA by specialty
• Technician/Technologist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.