Individual provider Active NPI

Matthew Philip Laurie, O.D.

  • Optometrist
  • Olathe, KS
National Provider Identifier
1073559274
Registry record updated Dec 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
KS1599 Issued in KS
Practice address
12120 S Strang Line Rd
Olathe, KS 66062-5219
Phone
(913) 307-9200
Fax
(913) 307-9200
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X KS1599 KS Primary
Optometrist 152W00000X 2000166654 MO
Optometrist 152W00000X OPC 3482 FL

Addresses

Primary practice location

12120 S Strang Line Rd
Olathe, KS 66062-5219

Mailing address

13801 Cedar St
Leawood, KS 66224-1119
Phone (913) 307-9200

Other identifiers 1

IdentifierTypeStateIssuer
100423680AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20050920000571 KS Practitioner - Optometry 1456385475 Practice locations: Olathe, KS

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12120 S Strang Line Rd
Olathe, KS 66062-5219
Phone (913) 397-9111

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery20

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 3482FLMDOptometrist
KS1599KSMDOptometrist
2000166654MOMDOptometrist
1599KSMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Hunkeler Eye Institute PA Optometrist Past Accepting new patients
Vision Today Past Accepting new patients
My Eye Care LLC Optometrist Past Accepting new patients

Organizations & group practices 3

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260230400000",
    "number": "1073559274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13801 CEDAR ST",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662241119",
            "telephone_number": "913-307-9200",
            "fax_number": "913-307-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12120 S STRANG LINE RD",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660625219",
            "telephone_number": "913-307-9200",
            "fax_number": "913-307-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURIE",
        "first_name": "MATTHEW",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2009-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "KS1599",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2000166654",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 3482",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100423680A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

Verify at the official NPI Registry.