Mark L Siefkes, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1539 Issued in KS

Practice address

10120 W 119TH St
Overland Park, KS 66213

Phone

(913) 339-9090

Fax

(913) 339-6417

NPI assigned

Dec 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in KS

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

University of Missouri St Louis - School of Optometry, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Associates of Overland Park PAGroup PAC ID 3375515596, 10 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.

• Eye Associates of Overland Park PA

  • Optometrist
  • Overland Park, KS
  • NPI 1316009129

  KS, Optometrist

  Medicare reassignment Care Compare group NPD
• Eye Associates of South Overland Park

  • Optometrist
  • Overland Park, KS
  • NPI 1417495797

  KS, Optometrist

  Medicare reassignment NPD Authorized official
• Eye Associates of North Overland Park

  • Optometrist
  • Overland Park, KS
  • NPI 1932856994

  KS, Optometrist

  Medicare reassignment NPD
• Eye Associates of Olathe PA

  • Optometrist
  • Olathe, KS
  • NPI 1245392059

  KS, Optometrist

  Medicare reassignment NPD
• Eye Associates of Prairie Village,PA

  • Optometrist
  • Prairie Village, KS
  • NPI 1932466513

  KS, Optometrist

  Medicare reassignment NPD
• Eye Associates of Shawnee PA

  • Optometrist
  • Shawnee, KS
  • NPI 1316009111

  KS, Optometrist

  Medicare reassignment NPD
• Eye Associates of South Olathe

  • Optometrist
  • Olathe, KS
  • NPI 1952731846

  KS, Optometrist

  Medicare reassignment NPD
• Eye Associates of Leawood PA

  • Optometrist
  • Leawood, KS
  • NPI 1043331622

  KS

  Medicare reassignment

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240185600000",
    "number": "1285793786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10120 W 119TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66213",
            "telephone_number": "913-339-9090",
            "fax_number": "913-339-6417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10120 W 119TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66213",
            "telephone_number": "913-339-9090",
            "fax_number": "913-339-6417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEFKES",
        "first_name": "MARK",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2009-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSKC FOR EYE ASSOCIATES OF LEAWOOD",
            "identifier": "25757045",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B FOR EYE ASSOCIATES OF SHAWNEE",
            "identifier": "R178660",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSKC FOR EYE ASSOCIATES OF SHAWNEE",
            "identifier": "25757035",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE FOR EYE ASSOCIATES OF OVERLAND PARK",
            "identifier": "410043137",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSKC FOR EYE ASSOCIATES OF OVERLAND PARK",
            "identifier": "25757015",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSKC FOR EYE ASSOCIATES OF OLATHE",
            "identifier": "25757025",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5109645",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B FOR EYE ASSOCIATES OF OVERLAND PARK",
            "identifier": "R198660",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B FOR EYE ASSOCIATES OF LEAWOOD",
            "identifier": "KA1109006",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B FOR EYE ASSOCIATES OF OLATHE",
            "identifier": "R188660",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie A Shull, PA-C
• Josiah Shultz
• Kristen Marie Sibold, OTR
• Fatima Zulfigar Siddiqui
• Kiley Conrad Siebs, PHARMD
• Patricia Siemann, MA, L/CCC-SLP
• James Sigler, MD
• Signature Medical Group of KC PA
• Signature Medical Group of KC PA
• Signature Medical Group of KC, P.a.

• All providers in Overland Park, KS
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; 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.