NPIMap

Organization Active NPI

International Eyecare Center Inc

Doing business as Malbar Vision

  • Optometrist
  • Omaha, NE
National Provider Identifier
1386825610
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
INTERNATIONAL EYECARE CENTER INC
Doing business as
Malbar Vision
Practice address
2545 S 132ND St
Omaha, NE 68144-2532
Phone
(402) 330-1060
Fax
(402) 330-6134
NPI assigned
Nov 15, 2007
Last updated
Jan 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Authorized official

Name
Cathy Lee Short
Title
Credentialing Manager
Phone
(618) 462-9818

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 470486594 NE
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

2545 S 132ND St
Omaha, NE 68144-2532

Mailing address

409 N 78TH St
Omaha, NE 68114-3638
Phone (402) 393-4500

Other identifiers 1

IdentifierTypeStateIssuer
47048659406MedicaidNE

Other names 1

  • Malbar Vision Doing business as

National Provider Directory

National Provider Directory

Locations

201 N Madison St
Pittsfield, IL 62363
Phone (217) 285-4000

210 Steamboat Bend Shopping Ctr
Hannibal, MO 63401
Phone (573) 248-1616

215 E Jackson St
Mexico, MO 65265
Phone (573) 581-7007

3200 O St
Ste A
Lincoln, NE 68510
Phone (402) 475-9113

2545 S 132nd St
Omaha, NE 68144
Phone (402) 330-1060

2545 S 132nd St
#1071
Omaha, NE 68144
Phone (402) 330-4330

409 N 78th St
#1072
Omaha, NE 68114
Phone (402) 391-6600

Practitioners & affiliated clinicians

Practitioners 42

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 42

NPI Registry JSON

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611273600000",
    "number": "1386825610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 N 78TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143638",
            "telephone_number": "402-393-4500",
            "fax_number": "402-393-7457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 S 132ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442532",
            "telephone_number": "402-330-1060",
            "fax_number": "402-330-6134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL EYECARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A",
        "authorized_official_last_name": "SHORT",
        "authorized_official_first_name": "CATHY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "618-462-9818"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NE",
            "license": "470486594",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47048659406",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Malbar Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.