Individual provider Active NPI

Joseph Charles Urbaitis, O.D.

  • Optometrist
  • Bettendorf, IA
National Provider Identifier
1497776983
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1999 Issued in IA
Practice address
3625 Utica Ridge Rd
Bettendorf, IA 52722-1646
Phone
(563) 355-4716
Fax
(563) 355-5034
NPI assigned
Jul 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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 1999 IA Primary

Addresses

Primary practice location

3625 Utica Ridge Rd
Bettendorf, IA 52722-1646

Mailing address

3625 Utica Ridge Rd
Bettendorf, IA 52722-1646
Phone (563) 355-4716

Other identifiers 3

IdentifierTypeStateIssuer
UR702901OtherIACLARITY
1089482MedicaidIA
2864030001OtherIADMERC

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
I20120202000386 IA Practitioner - Optometry 9931300845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3279 Utica Ridge Rd
Bettendorf, IA 52722-1613
Phone (563) 355-4716

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1999IAMDOptometrist
01999IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Waddingham-Urbaitis and Associates PC Optometrist CurrentSince Apr 3, 1997 Accepting new patients

Locations

3279 Utica Ridge Rd
Bettendorf, IA 52722
Phone (563) 355-4716

3625 Utica Ridge Rd
Bettendorf, IA 52722
Phone (563) 355-4716

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497776983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 UTICA RIDGE RD",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221646",
            "telephone_number": "563-355-4716",
            "fax_number": "563-355-5034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 UTICA RIDGE RD",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221646",
            "telephone_number": "563-355-4716",
            "fax_number": "563-355-5034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URBAITIS",
        "first_name": "JOSEPH",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "1999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLARITY",
            "identifier": "UR702901",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1089482",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "2864030001",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

Verify at the official NPI Registry.