Active NPI
F Duane Kovarik, O.D.
- Optometrist
- Grand Island, NE
National Provider Identifier
1174610596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 840
- Practice address
- 3404 W. 13TH St.
Ste 105
Grand Island, NE 68803-2392 - Phone
- (308) 382-6928
- NPI assigned
- Oct 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 840 | NE | Primary |
Addresses
Primary practice location
3404 W. 13TH St.
Ste 105
Grand Island, NE 68803-2392
Mailing address
402 Valley View Dr.
Ord, NE 68862-1651
Phone (308) 728-5778
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47060515300 | Medicaid | NE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 840 | NE | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc. | Past | Accepting new patients | |
| Luxottica of America Inc | Past | Accepting new patients |
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.
-
- Eyewear Supplier
- Grand Island, NE
- NPI 1649325143
-
- Eyewear Supplier
- Kansas City, MO
- NPI 1497412522
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219795200000",
"number": "1174610596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 VALLEY VIEW DR.",
"city": "ORD",
"state": "NE",
"postal_code": "688621651",
"telephone_number": "308-728-5778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3404 W. 13TH ST.",
"address_2": "STE 105",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688032392",
"telephone_number": "308-382-6928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOVARIK",
"first_name": "F",
"middle_name": "DUANE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-06",
"last_updated": "2008-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NE",
"license": "840",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47060515300",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Island, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.