NPIMap

Organization Active NPI

Kansas City Eye Clinic, P.a.

  • Ophthalmology Physician
  • Overland Park, KS
National Provider Identifier
1063622124
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
KANSAS CITY EYE CLINIC, P.A.
Practice address
7504 Antioch Rd
Overland Park, KS 66204-2622
Phone
(913) 341-3100
NPI assigned
May 23, 2007
Last updated
Oct 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Authorized official

Name
Sara S OconnellNPI 1780671560
Title
President
Phone
(913) 341-3100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X KS
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

7504 Antioch Rd
Overland Park, KS 66204-2622

Mailing address

7504 Antioch Rd
Overland Park, KS 66204-2622
Phone (913) 341-3100

Other practice location 1

4061 Indian Creek Pkwy Ste 310
Overland Park, KS 66207-4030
Phone (913) 341-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040813001016 KS Part B Supplier - Clinic/Group Practice 0143206102 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
Practice locations: Overland Park, KS
O20100930002623 KS DME Supplier - Physician - OphthalmologyDME Supplier - Physician - Optometrist 0143206102 Practice locations: Overland Park, KS

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D2079905Kansas City Eye Clinic7504 Antioch Road, Overland Park, KS 66204Certificate of waiverJan 15, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Kansas City Eye Clinic7504 Antioch Rd, Overland Park, KS 66204-2622(913) 341-3100 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Aug 10, 1990

National Provider Directory

National Provider Directory
Tax ID family
Kansas City Eye Clinic PA2 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.

Locations

4061 Indian Creek Pkwy
Ste 310
Overland Park, KS 66207
Phone (913) 341-3100

7504 Antioch Rd
Overland Park, KS 66204
Phone (913) 341-3100

Practitioners & affiliated clinicians

Practitioners 12

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": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1063622124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7504 ANTIOCH RD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662042622",
            "telephone_number": "913-341-3100",
            "fax_number": "913-341-6818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7504 ANTIOCH RD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662042622",
            "telephone_number": "913-341-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4061 Indian Creek Pkwy Ste 310",
            "address_purpose": "LOCATION",
            "city": "Overland Park",
            "state": "KS",
            "postal_code": "662074030",
            "country_code": "US",
            "telephone_number": "913-341-3100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KANSAS CITY EYE CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "OCONNELL",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "913-341-3100"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.