Individual provider Active NPI

Roger Patrick Neal, OD

  • Optometrist
  • North Little Rock, AR
National Provider Identifier
1376582817
Registry record updated Jun 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2316 Issued in AR
Practice address
2524 Crestwood Rd
North Little Rock, AR 72116-7623
Phone
(501) 758-3050
Fax
(501) 758-5052
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2316 AR Primary

Addresses

Primary practice location

2524 Crestwood Rd
North Little Rock, AR 72116-7623

Mailing address

3004 E Kiehl Ave
Sherwood, AR 72120-3228
Phone (501) 758-3050

Other identifiers 1

IdentifierTypeStateIssuer
113267722MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20060614000318 AR Practitioner - Optometry 0941211338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Eye ClinicGroup PAC ID 0042221434, 3 clinicians

Practice addresses (Care Compare)

3004 E Kiehl Ave
Sherwood, AR 72120-3228
Phone (501) 835-7800

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2316ARMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Eye Clinic Optometrist CurrentSince Jun 1, 1998 Accepting new patients

Locations

15424 Arch St
Ste F
Little Rock, AR 72206
Phone (501) 888-7533

15424 Arch St
Little Rock, AR 72206
Phone (501) 261-5000

2524 Crestwood Rd
North Little Rock, AR 72116
Phone (501) 758-3050

3004 E Kiehl Ave
Sherwood, AR 72120
Phone (501) 791-3076

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1376582817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 E KIEHL AVE",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721203228",
            "telephone_number": "501-758-3050",
            "fax_number": "501-758-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2524 CRESTWOOD RD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721167623",
            "telephone_number": "501-758-3050",
            "fax_number": "501-758-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "ROGER",
        "middle_name": "PATRICK",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113267722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

Verify at the official NPI Registry.