Organization Active NPI

Eye Health Solutions PC

  • Optometrist
  • Knoxville, IA
National Provider Identifier
1487637443
Registry record updated Sep 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
02116 Issued in IA
Legal business name
EYE HEALTH SOLUTIONS PC
Practice address
100 S 5TH St
Knoxville, IA 50138-1712
Phone
(641) 842-4575
Fax
(641) 842-5453
NPI assigned
Nov 23, 2005
Last updated
Sep 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2009

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

Authorized official

Name
Dr. Jason Maasdam, O.D.NPI 1922081678
Title
Optometrist
Phone
(641) 842-3616

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
Optometrist 152W00000X 02116 IA Primary

Addresses

Primary practice location

100 S 5TH St
Knoxville, IA 50138-1712

Mailing address

100 S 5TH St
Knoxville, IA 50138-1712
Phone (641) 842-3616

Other identifiers 2

IdentifierTypeStateIssuer
0252510MedicaidIA
48880OtherIABLUE CROSS GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040928001174 IA Part B Supplier - Clinic/Group Practice 5890764666 Receives reassigned benefits from 3 practitioners
Practice locations: Knoxville, IA
O20100930056330 IA DME Supplier - Physician - Optometrist 5890764666 Practice locations: Knoxville, IA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Eye Health Solutions PC100 S 5TH St, Knoxville, IA 50138-1712(641) 842-3616 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 2, 2002

National Provider Directory

National Provider Directory

Locations

100 S 5th St
Knoxville, IA 50138
Phone (641) 842-3616

206 E Robinson St
Knoxville, IA 50138
Phone (515) 842-3616

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253059200000",
    "number": "1487637443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S 5TH ST",
            "city": "KNOXVILLE",
            "state": "IA",
            "postal_code": "501381712",
            "telephone_number": "641-842-3616",
            "fax_number": "641-842-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S 5TH ST",
            "city": "KNOXVILLE",
            "state": "IA",
            "postal_code": "501381712",
            "telephone_number": "641-842-4575",
            "fax_number": "641-842-5453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE HEALTH SOLUTIONS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-23",
        "last_updated": "2009-09-16",
        "status": "A",
        "authorized_official_last_name": "MAASDAM",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "641-842-3616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0252510",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP NUMBER",
            "identifier": "48880",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.