Active NPI
North Iowa Eye Clinic, P.C.
- Ophthalmology Physician
- Mason City, IA
National Provider Identifier
1497863559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- Legal business name
- NORTH IOWA EYE CLINIC, P.C.
- Practice address
- 3121 4TH St SW
Mason City, IA 50401-1581 - Phone
- (641) 423-8861
- Fax
- (641) 423-0727
- NPI assigned
- Aug 29, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Randall Scott Brenton, M.D.
- Title
- President
- Phone
- (641) 423-8861
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | Primary |
Addresses
Primary practice location
3121 4TH St SW
Mason City, IA 50401-1581
Mailing address
PO Box 1877
Mason City, IA 50402-1877
Phone (641) 423-8861
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24594 | Other | IA | PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040322001910 | IA | Part B Supplier - Clinic/Group Practice | 8426949173 |
Receives reassigned benefits from 6 practitioners Practice locations: Charles City, IA; Mason City, IA; Osage, IA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D2063034 | North Iowa Eye Clinic, PC | Certificate of waiver | Jul 24, 2027 |
National Provider Directory
National Provider DirectoryLocations
3121 4th St SW
#1877
Mason City, IA 50401
Practitioners & affiliated clinicians
Practitioners 6
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": "1156809600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1430352000000",
"number": "1497863559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1877",
"city": "MASON CITY",
"state": "IA",
"postal_code": "504021877",
"telephone_number": "641-423-8861",
"fax_number": "641-423-0727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3121 4TH ST SW",
"city": "MASON CITY",
"state": "IA",
"postal_code": "504011581",
"telephone_number": "641-423-8861",
"fax_number": "641-423-0727"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTH IOWA EYE CLINIC, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-29",
"last_updated": "2015-04-30",
"status": "A",
"authorized_official_last_name": "BRENTON",
"authorized_official_first_name": "RANDALL",
"authorized_official_middle_name": "SCOTT",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "641-423-8861",
"authorized_official_credential": "M.D."
},
"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": "PTAN",
"identifier": "24594",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mason City, IA
- North Iowa Community Action Organization
- North Iowa Community Action Organization
- North Iowa Community Action Organization
- North Iowa Community Action Organization
- North Iowa Eye Clinic, P.C.
- North Iowa Family Health Care PLC
- North Iowa Mercy Clincis
- North Iowa Mercy Clinics
- North Iowa Mercy Clinics
- North Iowa Mercy Clinics
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; 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.