NPIMap

Organization Active NPI

Eyeconic Eyecare LLC

  • Optometrist
  • Independence, MO
National Provider Identifier
1124347513
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYECONIC EYECARE LLC
Practice address
18931 E Valley View Pkwy
Suite H
Independence, MO 64055-7012
Phone
(816) 795-8884
NPI assigned
May 24, 2010
Last updated
Mar 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Authorized official

Name
Dr. Michael J Hawk, O.D.NPI 1003979816
Title
Optometrist / Owner
Phone
(816) 308-9132

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary
Eyewear Supplier 332H00000X 2004004593 MO

Addresses

Primary practice location

18931 E Valley View Pkwy
Suite H
Independence, MO 64055-7012

Mailing address

18931 E Valley View Pkwy
Suite H
Independence, MO 64055-7012
Phone (816) 795-8884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100813000937 MO Part B Supplier - Clinic/Group Practice 8224162144 Receives reassigned benefits from 2 practitioners
Practice locations: Independence, MO

National Provider Directory

National Provider Directory

Locations

18931 E Valley View Pkwy
Ste H
Independence, MO 64055
Phone (816) 795-8884

Practitioners & affiliated clinicians

Practitioners 2

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": "1274659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646956800000",
    "number": "1124347513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18931 E VALLEY VIEW PKWY",
            "address_2": "SUITE H",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640557012",
            "telephone_number": "816-795-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18931 E VALLEY VIEW PKWY",
            "address_2": "SUITE H",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640557012",
            "telephone_number": "816-795-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECONIC EYECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-24",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A",
        "authorized_official_last_name": "HAWK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OPTOMETRIST / OWNER",
        "authorized_official_telephone_number": "816-308-9132",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MO",
            "license": "2004004593",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.