Benjamin J Lundeen, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

8605TG Issued in TX

Practice address

5044 Tennyson Pkwy Ste B
Plano, TX 75024-2953

Phone

(972) 378-4104

Fax

(972) 378-9094

NPI assigned

Feb 25, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Other, 2012

Medicare assignment

May accept Medicare assignment

Group practices

Todd R Brantley LLCGroup PAC ID 7416194725, 4 clinicians

Todd Brantley, OD PAGroup PAC ID 4284760414, 6 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.

• Todd Brantley, OD PA

  • Optometrist
  • Plano, TX
  • NPI 1790931632
  Medicare reassignment Care Compare group NPD
• Todd R. Brantley, LLC

  • Optometrist
  • Celina, TX
  • NPI 1215278510
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1330128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1295009041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5044 TENNYSON PKWY STE B",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750242953",
            "telephone_number": "972-378-4104",
            "fax_number": "972-378-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5044 TENNYSON PKWY STE B",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750242953",
            "telephone_number": "972-378-4104",
            "fax_number": "972-378-9094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDEEN",
        "first_name": "BENJAMIN",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-25",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2739",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8605TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karri Luna, LCSW
• Leslie Luna, LMT
• Earl R Lund, M.D.
• Karen Ann Lund, M.D.
• Kevin Lunde, M.D.
• Kolby Lundgren
• Jonathan Michael Lundmark
• Lungstar Pulmonary Diagnostic Services, Inc.
• Lungstar Sleep Diagnostics, Inc.
• Nicole M Luong

• Optometrist in Plano, TX
• Providers in Plano, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; 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.