Organization Active NPI

Eyecare Associates of Osawatomie, P.a.

  • Optometrist
  • Osawatomie, KS
National Provider Identifier
1073837464
Registry record updated Nov 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1713 Issued in KS
Legal business name
EYECARE ASSOCIATES OF OSAWATOMIE, P.A.
Practice address
524 Brown Ave
Osawatomie, KS 66064-1322
Phone
(913) 256-2176
Fax
(913) 755-2787
NPI assigned
Mar 15, 2010
Last updated
Nov 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2010

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

Authorized official

Name
Dr. Kari J Burchett, O.D.
Title
Optometris/ Doctor
Phone
(913) 256-2176

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12532 KS
Optometrist 152W00000X 11942 KS
Optometrist 152W00000X 1713 KS Primary

Addresses

Primary practice location

524 Brown Ave
Osawatomie, KS 66064-1322

Mailing address

PO Box 456
Osawatomie, KS 66064-0456
Phone (913) 256-2176

Other identifiers 10

IdentifierTypeStateIssuer
100218090AMedicaidKS
200357920AMedicaidKS
650544OtherKSMEDICARE ID-TYPE UNSPECIFIED
410014216OtherKSRAILROAD MEDICARE
P00355811OtherKSRAILROAD MEDICARE
410020656OtherKSRAILROAD MEDICARE
100218260AMedicaidKS
CA0104OtherKSRAILROAD MEDICARE
KA1721OtherKSMEDICARE ID-TYPE UNSPECIFIED
DQ3063OtherKSRAILROAD MEDICARE

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100609000884 KS Part B Supplier - Clinic/Group Practice 9335279827 Receives reassigned benefits from 4 practitioners
Practice locations: Osawatomie, KS
O20100930087443 KS DME Supplier - Physician - OptometristDME Supplier - Optician 9335279827 Practice locations: Osawatomie, KS

National Provider Directory

National Provider Directory
Tax ID family
Eyecare Associates of Osawatomie 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.

Practitioners & affiliated clinicians

Practitioners 5

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": "1268611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289174400000",
    "number": "1073837464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 456",
            "city": "OSAWATOMIE",
            "state": "KS",
            "postal_code": "660640456",
            "telephone_number": "913-256-2176",
            "fax_number": "913-755-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 BROWN AVE",
            "city": "OSAWATOMIE",
            "state": "KS",
            "postal_code": "660641322",
            "telephone_number": "913-256-2176",
            "fax_number": "913-755-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE ASSOCIATES OF OSAWATOMIE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-15",
        "last_updated": "2010-11-08",
        "status": "A",
        "authorized_official_last_name": "BURCHETT",
        "authorized_official_first_name": "KARI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OPTOMETRIS/ DOCTOR",
        "authorized_official_telephone_number": "913-256-2176",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "12532",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "11942",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100218090A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200357920A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE UNSPECIFIED",
            "identifier": "650544",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410014216",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00355811",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410020656",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100218260A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA0104",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE UNSPECIFIED",
            "identifier": "KA1721",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DQ3063",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Osawatomie, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; 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.