Organization Active NPI

Hilltop Eyecare PLLC

Doing business as Hillto Eye Care

  • Optometrist
  • Jonesboro, AR
National Provider Identifier
1447584396
Registry record updated Sep 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
PC-148 Issued in AR
Legal business name
HILLTOP EYECARE PLLC
Doing business as
Hillto Eye Care
Practice address
3705 E Johnson Ave
Jonesboro, AR 72401-1858
Phone
(870) 336-2452
NPI assigned
Sep 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2009

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

Authorized official

Name
Jacob Paul Moll, O.D.NPI 1942493234
Title
Chief Organizer
Phone
(870) 336-2452

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 PC-148 AR Primary

Addresses

Primary practice location

3705 E Johnson Ave
Jonesboro, AR 72401-1858

Mailing address

3705 E Johnson Ave
Jonesboro, AR 72401-1858
Phone (870) 336-2452

Other identifiers 1

IdentifierTypeStateIssuer
175609722MedicaidAR

Other names 1

  • Hillto Eye Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121102000214 AR Part B Supplier - Clinic/Group Practice 1153572946 Receives reassigned benefits from 3 practitioners
Practice locations: Jonesboro, AR

National Provider Directory

National Provider Directory

Locations

3705 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 336-2452

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1253750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253750400000",
    "number": "1447584396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 E JOHNSON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724011858",
            "telephone_number": "870-336-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 E JOHNSON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724011858",
            "telephone_number": "870-336-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLTOP EYECARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-24",
        "last_updated": "2009-09-24",
        "status": "A",
        "authorized_official_last_name": "MOLL",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF ORGANIZER",
        "authorized_official_telephone_number": "870-336-2452",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AR",
            "license": "PC-148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175609722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hillto Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.