Individual provider Active NPI

Jason Pfeifer, OD

  • Optometrist
  • Coralville, IA
National Provider Identifier
1497765457
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2306 Issued in IA
Practice address
2056 8TH St
Coralville, IA 52241-1502
Phone
(319) 338-9381
Fax
(319) 466-4662
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2306 IA Primary

Addresses

Primary practice location

2056 8TH St
Coralville, IA 52241-1502

Mailing address

2056 8TH St
Coralville, IA 52241-1502
Phone (319) 338-9381

Other identifiers 3

IdentifierTypeStateIssuer
42253OtherIADAVIS VISION
37525OtherIABC/BS
0450890MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070912000655 IA Practitioner - Optometry 5193818755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3400 Edgewood Rd SW
Cedar Rapids, IA 52404-7214
Phone (319) 396-5005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2306IAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
WJC LTD Optometrist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497765457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2056 8TH ST",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522411502",
            "telephone_number": "319-338-9381",
            "fax_number": "319-466-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2056 8TH ST",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522411502",
            "telephone_number": "319-338-9381",
            "fax_number": "319-466-4662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFEIFER",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "2306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "42253",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "37525",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0450890",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coralville, IA

Sources for this page

Verify at the official NPI Registry.