Individual provider Active NPI

Joshua Clyde Cantrell, OD

  • Optometrist
  • Lee's Summit, MO
National Provider Identifier
1326087594
Registry record updated Jul 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
MO2003000960 Issued in MO
Practice address
215 SE State Route 291
Lees Summit, MO 64063-2939
Phone
(816) 246-7779
Fax
(816) 246-7780
NPI assigned
Jun 5, 2006
Last updated
Jul 1, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X MO2003000960 MO Primary
Optometrist 152W00000X 1616 KS

Addresses

Primary practice location

215 SE State Route 291
Lees Summit, MO 64063-2939

Mailing address

215 SE State Route 291
Lees Summit, MO 64063-2939
Phone (816) 246-7779

Other identifiers 1

IdentifierTypeStateIssuer
33864028OtherMOBCBS

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20060919000274 MO Practitioner - Optometry 5890790240 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Eye Center LLCGroup PAC ID 8921309329, 6 clinicians
Envision Eyecare LLCGroup PAC ID 2365447711, 2 clinicians

Practice addresses (Care Compare)

1621 NW Blue Pkwy
Lees Summit, MO 64086-5708
Phone (816) 246-2111

700 E Langsford Rd
Lees Summit, MO 64063-2979
Phone (816) 246-7777

Merit-based Incentive Payment System (MIPS)

Final score
92.03 of 100Reported as group
Quality
95.69
Improvement activities
40
Cost
79.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1616KSMDAddiction (Substance Use Disorder) Counselor
MO2003000960MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Envision Eyecare, LLC Optometrist CurrentSince Jun 12, 2006 Accepting new patients
Summit Eye Center, LLC CurrentSince May 15, 2024 Accepting new patients

Locations

1621 NW Blue Pkwy
Lees Summit, MO 64086
Phone (816) 246-2111

215 SE State Route 291
Lees Summit, MO 64063
Phone (816) 246-7779

700 E Langsford Rd
Lees Summit, MO 64063
Phone (816) 246-7777

3400 W 10th St
Sedalia, MO 65301
Phone (660) 827-1120

103 Cottonwood St
Warsaw, MO 65355
Phone (660) 428-1146

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214870400000",
    "number": "1326087594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SE STATE ROUTE 291",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632939",
            "telephone_number": "816-246-7779",
            "fax_number": "816-246-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 SE STATE ROUTE 291",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632939",
            "telephone_number": "816-246-7779",
            "fax_number": "816-246-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTRELL",
        "first_name": "JOSHUA",
        "middle_name": "CLYDE",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2008-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "MO2003000960",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1616",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "33864028",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

Verify at the official NPI Registry.