Heartland Vision Center PA
Organization Active NPI Optometrist · Pittsburg, KS
NPI 1215075973 · NPPES record last updated Dec 5, 2007
Key facts
- NPI
- 1215075973
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- HEARTLAND VISION CENTER PA
- Practice address
- 2305 S Tucker St
Pittsburg, KS 66762-6530 - Phone
- (620) 232-2020
- NPI assigned
- Feb 2, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Dustin James Brooks, O.D.
- Title
- Secretary
- Phone
- (620) 232-2020
Practitioners 4
-
Thomas C. Brooks, O.D.
-
Wayne R Gilmore, O.D.
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Heartland Vision Center |
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040429001300 | KS | Part B Supplier - Clinic/Group Practice | 4688661614 |
Receives reassigned benefits from 2 practitioners Practice locations: Columbus, KS; Pittsburg, KS |
| O20100930072281 | KS | DME Supplier - Physician - Optometrist | 4688661614 | Practice locations: Pittsburg, KS |
National Provider Directory
Locations
2305 S Tucker St
Pittsburg, KS 66762
Phone (316) 232-2020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
2305 S Tucker St
Pittsburg, KS 66762-6530
Mailing address
2305 S Tucker St
Pittsburg, KS 66762-6530
Other providers in Pittsburg, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.