Organization Active NPI

Bridge Hill Eye, LLC

  • Optometrist
  • Lenexa, KS
National Provider Identifier
1124546882
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BRIDGE HILL EYE, LLC
Practice address
13803 W 82ND Ter
Lenexa, KS 66215-4168
Phone
(816) 533-5336
NPI assigned
Sep 1, 2017
Last updated
Aug 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Authorized official

Name
Matthew Coury Broberg, ODNPI 1497130702
Title
Optometrist
Phone
(816) 533-5336

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

13803 W 82ND Ter
Lenexa, KS 66215-4168

Mailing address

13803 W 82ND Ter
Lenexa, KS 66215-4168
Phone (816) 533-5336

Other practice location 1

7325 W 79th St
Overland Park, KS 66204-2908
Phone (816) 533-5336

Other identifiers 1

IdentifierTypeStateIssuer
1497130702MedicaidMO

Other names 1

  • Bridge Hill, LLC Former legal business name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20171212000329 MO Part B Supplier - Clinic/Group Practice 6204194772 Receives reassigned benefits from 3 practitioners
Practice locations: Raytown, MO; Raymore, MO; Liberty, MO; Lees Summit, MO; Kansas City, MO; Belton, MO; Blue Springs, MO; Independence, MO
O20200430001196 KS Part B Supplier - Clinic/Group Practice 6204194772 Receives reassigned benefits from 3 practitioners
Practice locations: Lenexa, KS; Shawnee, KS; Prairie Village, KS; Overland Park, KS; Olathe, KS; Kansas City, KS

National Provider Directory

National Provider Directory

Locations

7325 W 79th St
Overland Park, KS 66204
Phone (816) 333-1500

20551 E Trinity Pl
Blue Springs, MO 64015
Phone (816) 367-2123

2580 Norterre Cir
#C
Liberty, MO 64068

Practitioners & affiliated clinicians

Practitioners 8

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": "1504224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755043200000",
    "number": "1124546882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13803 W 82ND TER",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662154168",
            "telephone_number": "816-533-5336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13803 W 82ND TER",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662154168",
            "telephone_number": "816-533-5336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7325 W 79th St",
            "address_purpose": "LOCATION",
            "city": "Overland Park",
            "state": "KS",
            "postal_code": "662042908",
            "country_code": "US",
            "telephone_number": "816-533-5336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRIDGE HILL EYE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-01",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A",
        "authorized_official_last_name": "BROBERG",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "COURY",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "816-533-5336",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497130702",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridge Hill, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lenexa, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; 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.