Eyecare Associates of Lewistown PC
Organization Active NPI Optometrist · Lewistown, MT
NPI 1245217199 · NPPES record last updated Mar 3, 2023
Key facts
- NPI
- 1245217199
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 555 (MT)
- Legal business name
- EYECARE ASSOCIATES OF LEWISTOWN PC
- Practice address
- 119 E Main St
Lewistown, MT 59457-1710 - Phone
- (406) 538-5488
- Fax
- (406) 538-3210
- NPI assigned
- Dec 30, 2005
- Organization subpart
- No
Authorized official
- Name
- Dr. Jason A Ricks, OD
- Title
- President
- Phone
- (406) 535-2020
Practitioners 4
-
Paige Nash, O.D.
-
Jason Alex Ricks, O.D.
-
Daniel Paul Dodd, O.D.
-
Charles Walter Peterson, O.D.
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Eyecare Associates of Lewistown PC |
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050802001325 | MT | Part B Supplier - Clinic/Group Practice | 6901834613 |
Receives reassigned benefits from 2 practitioners Practice locations: Lewistown, MT |
| O20100930071447 | MT | DME Supplier - Physician - Optometrist | 6901834613 | Practice locations: Lewistown, MT |
National Provider Directory
Locations
119 E Main St
Lewistown, MT 59457
Phone (406) 535-2020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 555 | MT | Yes |
Addresses
Primary practice location
119 E Main St
Lewistown, MT 59457-1710
Mailing address
PO Box 59
Lewistown, MT 59457-0059
Phone (406) 538-5488
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0483650 | Medicaid | MT | |
| P00227881 | Other | MT | RAIL ROAD MEDICARE |
Other providers in Lewistown, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2023. 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.