Individual provider Active NPI

Allyson Mertins, OD

  • Optometrist
  • Fayetteville, AR
National Provider Identifier
1093719957
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2462 Issued in AR
Practice address
1188 N Salem Rd
Suite 12
Fayetteville, AR 72704-8807
Phone
(479) 442-8400
Fax
(800) 807-8144
NPI assigned
Jun 9, 2005
Last updated
Apr 9, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2462 AR Primary

Addresses

Primary practice location

1188 N Salem Rd
Suite 12
Fayetteville, AR 72704-8807

Mailing address

1188 N Salem Rd
Suite 12
Fayetteville, AR 72704-8807
Phone (479) 442-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20060911000328 AR Practitioner - Optometry 4082618897 Receives reassigned benefits from 1 practitioner
Practice locations: Fayetteville, AR

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

640 N Garland Ave
Suite 110
Fayetteville, AR 72701-3072
Phone (479) 442-8400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2462ARMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mertins Family Eye Care, Inc. Optometrist CurrentSince Jan 1, 1990 Accepting new patients
McDonald Eye Services, PA Optometrist PastSince Aug 27, 2016 Accepting new patients
McDonald Eye Services, PA Optometrist Past Accepting new patients

Locations

1188 N Salem Rd
Ste 12
Fayetteville, AR 72704
Phone (479) 442-8400

640 N Garland Ave
Ste 110
Fayetteville, AR 72701
Phone (479) 442-8400

Practitioners & affiliated clinicians

Practitioners 1

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.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1093719957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1188 N SALEM RD",
            "address_2": "SUITE 12",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727048807",
            "telephone_number": "479-442-8400",
            "fax_number": "800-807-8144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1188 N SALEM RD",
            "address_2": "SUITE 12",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727048807",
            "telephone_number": "479-442-8400",
            "fax_number": "800-807-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERTINS",
        "first_name": "ALLYSON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-09",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.