Organization Active NPI

Dr Curtis Broek OD PC

  • Optometrist
  • Urbandale, IA
National Provider Identifier
1306971973
Registry record updated May 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DR CURTIS BROEK OD PC
Practice address
7030 Douglas Ave
Urbandale, IA 50322-3224
Phone
(515) 278-0123
Fax
(515) 278-6310
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2015

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

Authorized official

Name
Dr. Curtis Broek, O.D.NPI 1437220282
Title
President
Phone
(515) 278-0123

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

7030 Douglas Ave
Urbandale, IA 50322-3224

Mailing address

7030 Douglas Ave
Urbandale, IA 50322-3224
Phone (515) 278-0123

Other names 1

  • Curtis A. Broek OD PC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040413000697 IA Part B Supplier - Clinic/Group Practice 0446244370 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ames, IA; Urbandale, IA

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

Locations

7030 Douglas Ave
Urbandale, IA 50322
Phone (515) 278-0123

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432598400000",
    "number": "1306971973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7030 DOUGLAS AVE",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503223224",
            "telephone_number": "515-278-0123",
            "fax_number": "515-278-6310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7030 DOUGLAS AVE",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503223224",
            "telephone_number": "515-278-0123",
            "fax_number": "515-278-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR CURTIS BROEK OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2015-05-26",
        "status": "A",
        "authorized_official_last_name": "BROEK",
        "authorized_official_first_name": "CURTIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-278-0123",
        "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": [
        {
            "organization_name": "Curtis A. Broek OD PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Urbandale, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; 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.