NPIMap

Organization Active NPI

Cokingtin Eye Center PA

  • Ophthalmology Physician
  • Harrisonville, MO
National Provider Identifier
1477511335
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
COKINGTIN EYE CENTER PA
Practice address
2800 E Rock Haven Rd
Cass Medical Center
Harrisonville, MO 64701-4411
Phone
(913) 491-3737
Fax
(913) 469-6686
NPI assigned
May 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Authorized official

Name
Christine Balestrieri
Title
Ceo/Practice Administrator
Phone
(913) 491-3737

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

2800 E Rock Haven Rd
Cass Medical Center
Harrisonville, MO 64701-4411

Mailing address

5520 College Blvd
Ste 201
Overland Park, KS 66211-1630
Phone (913) 491-3737

Other identifiers 4

IdentifierTypeStateIssuer
31661011OtherFREEDOM NETWORK
506050319MedicaidMO
31661011OtherMOBCBSKC
31661011OtherPHP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060810000196 MO Part B Supplier - Clinic/Group Practice 9739182841 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
Practice locations: Sedalia, MO; Warrensburg, MO; Raymore, MO; Marshall, MO; Kansas City, MO; Independence, MO; Harrisonville, MO

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Cokingtin Eye Center PA4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

506 Burkarth Rd
Ste A
Warrensburg, MO 64093
Phone (660) 747-2202

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629936000000",
    "number": "1477511335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5520 COLLEGE BLVD",
            "address_2": "STE 201",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111630",
            "telephone_number": "913-491-3737",
            "fax_number": "913-469-6686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E ROCK HAVEN RD",
            "address_2": "CASS MEDICAL CENTER",
            "city": "HARRISONVILLE",
            "state": "MO",
            "postal_code": "647014411",
            "telephone_number": "913-491-3737",
            "fax_number": "913-469-6686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COKINGTIN EYE CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-23",
        "status": "A",
        "authorized_official_last_name": "BALESTRIERI",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "CEO/PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "913-491-3737"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREEDOM NETWORK",
            "identifier": "31661011",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "506050319",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSKC",
            "identifier": "31661011",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "31661011",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisonville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.