Beaverdale Eye PC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

BEAVERDALE EYE PC

Practice address

2628 Beaver Ave
Des Moines, IA 50310-3908

Phone

(515) 274-4141

Fax

(515) 274-4144

NPI assigned

Aug 27, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Blaine R Brunsen, O.D.NPI 1861423519

Title

Owner

Phone

(515) 274-4141

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Blaine R Brunsen, OD

  • Optometrist
  • Des Moines, IA
  • NPI 1861423519
  Medicare reassignment Care Compare group NPD Authorized official
• Kari Hellstern, O.D.

  • Optometrist
  • Marshalltown, IA
  • NPI 1538542717
  Medicare reassignment Care Compare group NPD
• Abby M. Thomas, O.D.

  • Optometrist
  • Winterset, IA
  • NPI 1841302320
  Medicare reassignment Care Compare group NPD
• Cara Vander Wilt, O.D.

  • Optometrist
  • Johnston, IA
  • NPI 1124012869
  Medicare reassignment NPD

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409097600000",
    "number": "1265832208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2628 BEAVER AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503103908",
            "telephone_number": "515-274-4141",
            "fax_number": "515-274-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2628 BEAVER AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503103908",
            "telephone_number": "515-274-4141",
            "fax_number": "515-274-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVERDALE EYE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-27",
        "last_updated": "2014-08-27",
        "status": "A",
        "authorized_official_last_name": "BRUNSEN",
        "authorized_official_first_name": "BLAINE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-274-4141",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janelle Beal, RPH
• Katy Beary
• Jessica Beattie
• Barbara A Beatty, MD
• Beautiful Life Counseling
• Jeffrey L Bebensee, MD
• Angela Durham Beckel, ARNP
• Chad William Becker, D.O.
• Kailee Becker
• Matthew Becker

• Optometrist in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.