Individual provider Active NPI

Eric O'Brien, OD

  • Optometrist
  • West Burlington, IA
National Provider Identifier
1386931921
Registry record updated Aug 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002520 Issued in IA
Practice address
324 W Agency Rd
West Burlington, IA 52655-1674
Phone
(319) 753-3115
NPI assigned
Jul 4, 2011
Last updated
Aug 5, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010504 IL
Optometrist 152W00000X 002520 IA Primary

Addresses

Primary practice location

324 W Agency Rd
West Burlington, IA 52655-1674

Mailing address

324 W Agency Rd
West Burlington, IA 52655-1674
Phone (319) 753-3115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110721000308 IA Practitioner - Optometry 2668640418 Reassigns benefits to 1 organization
I20110923000447 IL Practitioner - Optometry 2668640418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Eric Botts and Associates LLCGroup PAC ID 5991858011, 3 clinicians

Practice addresses (Care Compare)

1730 E Jackson St
Macomb, IL 61455-2531
Phone (309) 836-3373

324 W Agency Rd
West Burlington, IA 52655-1674
Phone (319) 753-3115

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002520IAMDOptometrist
046010504ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Eric Botts & Associates LLC Optometrist CurrentSince Jul 6, 2011 Accepting new patients

Locations

324 W Agency Rd
West Burlington, IA 52655
Phone (319) 753-2269

659 Knox Square Dr
Galesburg, IL 61401
Phone (309) 343-6870

1730 E Jackson St
Macomb, IL 61455
Phone (309) 833-1456

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, 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": "1309737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1386931921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 W AGENCY RD",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551674",
            "telephone_number": "319-753-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 W AGENCY RD",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551674",
            "telephone_number": "319-753-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "ERIC",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-04",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010504",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "002520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Burlington, IA

Sources for this page

Verify at the official NPI Registry.