Individual provider Active NPI

Remi Jean Miljavac, O.D.

  • Optometrist
  • Kansas City, MO
National Provider Identifier
1164700506
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2011024903 Issued in MO
Practice address
400 NW Barry Rd
Kansas City, MO 64155-2725
Phone
(816) 436-7800
NPI assigned
Aug 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2011024903 MO Primary

Addresses

Primary practice location

400 NW Barry Rd
Kansas City, MO 64155-2725

Mailing address

6418 N Mokane CT
Kansas City, MO 64151-1373
Phone (816) 262-2558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20111207000306 MO Practitioner - Optometry 7416122270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1717 W Jesse James Rd
Excelsior Springs, MO 64024-1801
Phone (816) 262-2558

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2011024903MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Scott Foster Optometrist PastSince May 4, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: remi.miljavac.1@16003.direct.athenahealth.com

Organizations & group practices 2

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": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1164700506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6418 N MOKANE CT",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641511373",
            "telephone_number": "816-262-2558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NW BARRY RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641552725",
            "telephone_number": "816-436-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILJAVAC",
        "first_name": "REMI",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-03",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2011024903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.