Kansas City Optical, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

KANSAS CITY OPTICAL, LLC

Doing business as

Eye Care Optical
Optica Latina

Practice address

4609 Independence Ave
Kansas City, MO 64124-2927

Phone

(913) 717-9296

NPI assigned

Mar 14, 2023

Last updated

Mar 14, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew Broberg, OD

Title

Owner

Phone

(913) 717-9296

Specialties & licenses 1

Addresses

Other names 2

• Eye Care Optical Doing business as
• Optica Latina Doing business as

Practitioners 1

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.

• Elizabeth Christine Everson, OD

  • Pediatric Optometrist
  • Overland Park, KS
  • NPI 1558032102
  NPD

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678752000000",
    "number": "1467153601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13803 W 82ND TER",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662154168",
            "telephone_number": "913-717-9296",
            "fax_number": "816-817-3769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4609 INDEPENDENCE AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641242927",
            "telephone_number": "913-717-9296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANSAS CITY OPTICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A",
        "authorized_official_last_name": "BROBERG",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-717-9296",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Care Optical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Optica Latina",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kansas City Metropolitan Ear Nose & Throat PA
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• Kansas City OB-GYN Physicians,P.C.
• Kansas City Occupational Healthcare
• Kansas City Oral Surgery & Implant Center
• Kansas City Pediatric Cardiology Associates
• Kansas City Pediatric Dentistry LLC
• Kansas City Pediatrics, LLC
• Kansas City Physician Partners Inc

• Optometrist in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.