NPIMap

Organization Active NPI

Eye Associates of Shawnee PA

  • Optometrist
  • Shawnee, KS
National Provider Identifier
1316009111
Registry record updated Apr 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYE ASSOCIATES OF SHAWNEE PA
Practice address
15951 W 65TH St
Shawnee, KS 66217
Phone
(913) 268-9190
Fax
(913) 268-2654
NPI assigned
Dec 15, 2006
Last updated
Apr 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2009

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

Authorized official

Name
Mr. Vincent A Pennipede, ODNPI 1437218484
Title
Owner
Phone
(913) 339-9090

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

15951 W 65TH St
Shawnee, KS 66217

Mailing address

10120 W 119TH St
Overland Park, KS 66213
Phone (913) 339-9090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051112000004 KS Part B Supplier - Clinic/Group Practice 5890767065 Receives reassigned benefits from 16 practitioners
Practice locations: Shawnee, KS

National Provider Directory

National Provider Directory

Locations

15951 W 65th St
Shawnee, KS 66217
Phone (913) 268-9190

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239235200000",
    "number": "1316009111",
    "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": "15951 W 65TH ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "66217",
            "telephone_number": "913-268-9190",
            "fax_number": "913-268-2654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE ASSOCIATES OF SHAWNEE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2009-04-09",
        "status": "A",
        "authorized_official_last_name": "PENNIPEDE",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-339-9090",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; 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.