Paul M Lackore, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1004 Issued in NE

Practice address

1437 N Webb Rd
Grand Island, NE 68803-2313

Phone

(308) 382-9205

Fax

(308) 382-3414

NPI assigned

Feb 24, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

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

Indiana University - School of Optometry, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heartland Optical Inc.Group PAC ID 6507921715, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• Heartland Optical Inc.

  • Optometrist
  • Lincoln, NE
  • NPI 1588699318
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1172275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265568406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1437 N WEBB RD",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688032313",
            "telephone_number": "308-382-9205",
            "fax_number": "308-382-3414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1437 N WEBB RD",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688032313",
            "telephone_number": "308-382-9205",
            "fax_number": "308-382-3414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKORE",
        "first_name": "PAUL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "6937",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maggie Sylvia Kuta
• Janice M Kutilek, MD
• Lisa Kvasnicka
• Yerisley Labrada Altunaga
• Julie Ann Labreche, RN
• Peggy Lackore, PT
• Stacy M Ladwig, PT DPT
• Mariah Corinne Lafrenz-Lechleitner
• Carolynne Corinne Lafrenz
• Yay Lagra Toirac

• Optometrist in Grand Island, NE
• Providers in Grand Island, NE by specialty
• Optometrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.