Individual provider Active NPI

Andrea M Needham, O.D.

  • Optometrist
  • Paola, KS
National Provider Identifier
1134435225
Registry record updated Aug 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1819 Issued in KS
Practice address
2 S Silver St
Paola, KS 66071-1469
Phone
(913) 951-7696
NPI assigned
Aug 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1819 KS Primary

Addresses

Primary practice location

2 S Silver St
Paola, KS 66071-1469

Mailing address

2 S Silver St
Paola, KS 66071-1469
Phone (913) 951-7696

Other identifiers 1

IdentifierTypeStateIssuer
200912130MedicaidKS

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
I20121004000585 KS Practitioner - Optometry 5395994479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2 S Silver St
Paola, KS 66071-1469
Phone (913) 294-2300

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1819KSMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecare Professionals, LLC Optometrist CurrentSince Aug 20, 2013 Accepting new patients
DRS Price Young Odle & Horsch PA Optometrist Past Accepting new patients
DRS Price Young Odle & Horsch PA Optometrist Past Accepting new patients

Locations

2 S Silver St
Paola, KS 66071
Phone (913) 294-2300

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": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375747200000",
    "number": "1134435225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 S SILVER ST",
            "city": "PAOLA",
            "state": "KS",
            "postal_code": "660711469",
            "telephone_number": "913-951-7696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 S SILVER ST",
            "city": "PAOLA",
            "state": "KS",
            "postal_code": "660711469",
            "telephone_number": "913-951-7696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEEDHAM",
        "first_name": "ANDREA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2013-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200912130",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paola, KS

Sources for this page

Verify at the official NPI Registry.