Ivan Bruce Bank, O.D. ,F.A.A.O.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

03313TG Issued in TX

Practice address

8611 Hillcrest Ave
Ste. 140
Dallas, TX 75225-4207

Phone

(214) 739-8611

Fax

(214) 739-8612

NPI assigned

Nov 9, 2005

Last updated

Jan 10, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Optometry

Education

Southern College of Optometry, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Texas Professional PLLCGroup PAC ID 4486985678, 228 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aeg Texas Professional PLLC

  • Optometrist
  • Kerrville, TX
  • NPI 1457905937
  Medicare reassignment Care Compare group NPD
• BWB Eye Care PLLC

  • Optometrist
  • Fort Worth, TX
  • NPI 1710622345

  Corneal and Contact Management

  NPD Authorized official
• Ivan B Bank OD PA Insight Complete Eyecare

  dba Insight Complete Eyecare

  • Optometrist
  • Dallas, TX
  • NPI 1710116330
  Authorized official Same address or phone
• Severn Eyecare Inc.

  dba St. Charles Vision

  • Optometrist
  • Metairie, LA
  • NPI 1225086689
  NPD (past) Authorized official
• SCV Vision Outlet Inc

  dba St Charles Vision Outlet Chateau

  • Optometrist
  • Kenner, LA
  • NPI 1881679934
  NPD (past)
• Timothy J Leach OD a Professional Optometrist Corporation

  dba St Charles Vision Severn

  • Optometrist
  • Metairie, LA
  • NPI 1306116462
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420848000000",
    "number": "1194706861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8611 HILLCREST AVE",
            "address_2": "STE. 140",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752254207",
            "telephone_number": "214-739-8611",
            "fax_number": "214-739-8612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8611 HILLCREST AVE",
            "address_2": "STE. 140",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752254207",
            "telephone_number": "214-739-8611",
            "fax_number": "214-739-8612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANK",
        "first_name": "IVAN",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "O.D. ,F.A.A.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2015-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "LA",
            "license": "930-108T",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "03313TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "721030686BA",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY HEALTHCARE",
            "identifier": "83020",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2264B",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Bangert
• Julie Catherine Bangle, LCSW (LINENSED CLINI
• David Banh, M.D.
• Delaney Vedros Banister, CRNA
• Bank Saland Associates
• Taylor Stephanie Bank, CCC-SLP
• Audrey Claire Bankes
• Mackenzie Bankes
• Austin Banks-Wilson, PT
• Amelia Nicole Banks, M.A.,BCBA,PCPL

• Corneal and Contact Management Optometrist in Dallas, TX
• Providers in Dallas, TX by specialty
• Corneal and Contact Management Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.