Organization Active NPI

Carthage Eye Care PC

  • Optometrist
  • Carthage, MO
National Provider Identifier
1366423766
Registry record updated Mar 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
CARTHAGE EYE CARE PC
Practice address
130 E 4TH St
Carthage, MO 64836-1627
Phone
(417) 358-2950
Fax
(417) 358-4204
NPI assigned
Nov 11, 2005
Last updated
Mar 9, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2018

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

Authorized official

Name
Dr. Tamra Leona Soriano, O.D.NPI 1588646582
Title
Owner
Phone
(417) 358-2950

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

130 E 4TH St
Carthage, MO 64836-1627

Mailing address

130 E 4TH St
Carthage, MO 64836-1627
Phone (417) 358-2950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100701000650 MO Part B Supplier - Clinic/Group Practice 6204967458 Receives reassigned benefits from 4 practitioners
Practice locations: Carthage, MO
O20100930014289 MO DME Supplier - Physician - Optometrist 6204967458 Practice locations: Carthage, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Carthage Eye Care PC130 E 4TH St, Carthage, MO 64836-1627(417) 358-2950 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Nov 1, 2003

National Provider Directory

National Provider Directory

Locations

130 E 4th St
Carthage, MO 64836
Phone (417) 358-2950

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520553600000",
    "number": "1366423766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E 4TH ST",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648361627",
            "telephone_number": "417-358-2950",
            "fax_number": "417-358-4204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E 4TH ST",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648361627",
            "telephone_number": "417-358-2950",
            "fax_number": "417-358-4204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARTHAGE EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-11",
        "last_updated": "2018-03-09",
        "status": "A",
        "authorized_official_last_name": "SORIANO",
        "authorized_official_first_name": "TAMRA",
        "authorized_official_middle_name": "LEONA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-358-2950",
        "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": []
}

Other providers in Carthage, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.