Individual provider Active NPI

Caitlyn Declue, OD

  • Optometrist
  • Little Rock, AR
National Provider Identifier
1205569068
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2849 Issued in AR
Practice address
201 Executive CT Unit a
Little Rock, AR 72205-4536
Phone
(501) 224-5658
NPI assigned
Jul 7, 2022
Last updated
Jul 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2849 AR Primary

Addresses

Primary practice location

201 Executive CT Unit a
Little Rock, AR 72205-4536

Mailing address

201 Executive CT Ste a
Little Rock, AR 72205-4536
Phone (501) 224-5658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20221004002656 AR Practitioner - Optometry 7618353343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Little Rock Eye Clinic LLPGroup PAC ID 3476535121, 17 clinicians

Practice addresses (Care Compare)

4104 Richards Rd
North Little Rock, AR 72117-2652
Phone (501) 224-5658

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
92.15
Promoting interoperability
92
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2849ARMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Little Rock Eye Clinic, LLP Optometrist CurrentSince Aug 1, 2022 Accepting new patients

Locations

201 Executive Ct
Ste A
Little Rock, AR 72205
Phone (501) 224-5658

4200 N Rodney Parham Rd
Little Rock, AR 72212
Phone (501) 224-5658

4200 N Rodney Parham Rd
Ste 101
Little Rock, AR 72212
Phone (501) 224-5658

9600 Baptist Health Dr
Ste 230
Little Rock, AR 72205
Phone (501) 224-5658

4104 Richards Rd
North Little Rock, AR 72117
Phone (501) 224-5658

4104 Richards Rd
Ste A
North Little Rock, AR 72117

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1205569068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 EXECUTIVE CT STE A",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722054536",
            "telephone_number": "501-224-5658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 EXECUTIVE CT UNIT A",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722054536",
            "telephone_number": "501-224-5658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECLUE",
        "first_name": "CAITLYN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2022-07-07",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.