Active NPI
Bruce D Oberhelman, O.D.
- Optometrist
- Manhattan, KS
National Provider Identifier
1295742583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1070-2
- Practice address
- 1331 Poyntz Ave
Manhattan, KS 66502-4362 - Phone
- (785) 537-2420
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1070-2 | KS | Primary |
Addresses
Primary practice location
1331 Poyntz Ave
Manhattan, KS 66502-4362
Mailing address
1331 Poyntz Ave
Manhattan, KS 66502
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100089950A | Medicaid | KS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930033949 | KS | DME Supplier - Physician - Optometrist | 6406902543 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Manhattan, KS |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1070-2 | KS | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212105600000",
"number": "1295742583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1331 POYNTZ AVE",
"city": "MANHATTAN",
"state": "KS",
"postal_code": "66502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1331 POYNTZ AVE",
"city": "MANHATTAN",
"state": "KS",
"postal_code": "665024362",
"telephone_number": "785-537-2420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBERHELMAN",
"first_name": "BRUCE",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2008-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "KS",
"license": "1070-2",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100089950A",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manhattan, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; 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.