Active NPI
Jeffrey A Netzel, O.D.
- Optometrist
- Bentonville, AR
National Provider Identifier
1235145046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2529
- Practice address
- 1720 S Walton Blvd
Ste 2
Bentonville, AR 72712-7172 - Phone
- (479) 271-2225
- Fax
- (479) 271-6225
- NPI assigned
- Aug 1, 2006
- Last updated
- May 29, 2008
- 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 | 2529 | AR | Primary |
Addresses
Primary practice location
1720 S Walton Blvd
Ste 2
Bentonville, AR 72712-7172
Mailing address
1720 S Walton Blvd
Ste 2
Bentonville, AR 72712-7172
Phone (479) 271-2225
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 149488722 | Medicaid | AR |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Southern College of Optometry, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1720 S Walton Blvd
Suite 2
Bentonville, AR 72712-7533
Phone (479) 271-2225
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2529 | AR | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jeff Netzel O.D. PA | Optometrist | Current | Accepting new patients |
Locations
1720 S Walton Blvd
Ste 2
Bentonville, AR 72712
Phone (479) 271-2225
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": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212019200000",
"number": "1235145046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1720 S WALTON BLVD",
"address_2": "STE 2",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727127172",
"telephone_number": "479-271-2225",
"fax_number": "479-271-6225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1720 S WALTON BLVD",
"address_2": "STE 2",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727127172",
"telephone_number": "479-271-2225",
"fax_number": "479-271-6225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NETZEL",
"first_name": "JEFFREY",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2008-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AR",
"license": "2529",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "149488722",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bentonville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.