Eyecare Center of Madison Prof LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EYECARE CENTER OF MADISON PROF LLC

Practice address

302 N Harth Ave
Madison, SD 57042-2219

Phone

(605) 256-6911

Fax

(605) 256-9017

NPI assigned

Sep 23, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Michael S BrookeNPI 1306854062

Title

Optometrist/Managing Member

Phone

(605) 256-6911

Specialties & licenses 1

Addresses

Other names 1

• Eyecare Center of Madison Doing business as

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Steven Brooke, OD

  • Optometrist
  • Madison, SD
  • NPI 1306854062
  Medicare reassignment NPD Authorized official
• Christian Dejongh

  • Optometrist
  • Madison, SD
  • NPI 1538892112
  Medicare reassignment NPD
• Jodie S Larson, OD

  • Optometrist
  • Madison, SD
  • NPI 1417942251
  Medicare reassignment NPD

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

{
    "created_epoch": "1348358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348358400000",
    "number": "1508117151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 N HARTH AVE",
            "city": "MADISON",
            "state": "SD",
            "postal_code": "570422219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 N HARTH AVE",
            "city": "MADISON",
            "state": "SD",
            "postal_code": "570422219",
            "telephone_number": "605-256-6911",
            "fax_number": "605-256-9017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE CENTER OF MADISON PROF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-23",
        "last_updated": "2012-09-23",
        "status": "A",
        "authorized_official_last_name": "BROOKE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OPTOMETRIST/MANAGING MEMBER",
        "authorized_official_telephone_number": "605-256-6911",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyecare Center of Madison",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jordan Elisabeth Eichacker, MS, RD, LN
• Gerald A. Elpert, D.D.S.
• Embrace Madison Dental LLC
• Jason Thomas Evans, D.C., D.I.B.C.N.
• Every Citizen Counts Organization
• Kristin K Fox, PT
• Edgar V Garcia, LMT
• Getting Well Chiropractic Prof, LLC
• Bradley Dale Gilbert, ATC
• Joseph Michael Gitzen, D.C.

• Optometrist in Madison, SD
• Providers in Madison, SD by specialty
• Optometrist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.