Organization Active NPI

North Iowa Eye Clinic, P.C.

  • Ophthalmology Physician
  • Mason City, IA
National Provider Identifier
1497863559
Registry record updated Apr 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
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

Updated by the provider on Apr 30, 2015

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)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
24594OtherIAPTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 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
16D2063034North Iowa Eye Clinic, PC3121 4TH Street SW, Mason City, IA 50401Certificate of waiverJul 24, 2027

National Provider Directory

National Provider Directory

Locations

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

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.

Verify at the official NPI Registry.