NPIMap

Organization Active NPI

Cokingtin Eye Center PA

  • Ophthalmology Physician
  • Overland Park, KS
National Provider Identifier
1497751648
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
COKINGTIN EYE CENTER PA
Practice address
5520 College Blvd
Ste 201
Overland Park, KS 66211-1658
Phone
(913) 491-3737
Fax
(913) 469-6686
NPI assigned
Jun 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 KS Primary

Addresses

Primary practice location

5520 College Blvd
Ste 201
Overland Park, KS 66211-1658

Mailing address

5520 College Blvd
Ste 201
Overland Park, KS 66211-1658
Phone (913) 491-3737

Other identifiers 9

IdentifierTypeStateIssuer
100449800AMedicaidKS
31661011OtherFREEDOM NETWORK
506050319MedicaidMO
468090OtherKSBCBSKS
506050301MedicaidMO
100138550DMedicaidKS
31661011OtherBCBSKC
17788OtherSPECTERA
31661011OtherPHP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060810000188 KS Part B Supplier - Clinic/Group Practice 9739182841 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Leawood, KS; Overland Park, KS; Lawrence, KS

Other NPIs on the same Medicare enrollment 1

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

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D2058422Cokingtin Eye Center5520 College Blvd Suite 201, Overland Park, KS 66211Certificate of waiverMay 6, 2027

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.

Practitioners & affiliated clinicians

Practitioners 10

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": "1119398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1497751648",
    "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": "662111658",
            "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": "5520 COLLEGE BLVD",
            "address_2": "STE 201",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111658",
            "telephone_number": "913-491-3737",
            "fax_number": "913-469-6686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COKINGTIN EYE CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-22",
        "last_updated": "2022-07-21",
        "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": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100449800A",
            "state": "KS"
        },
        {
            "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": "BCBSKS",
            "identifier": "468090",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "506050301",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100138550D",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSKC",
            "identifier": "31661011",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "17788",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "31661011",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.