Davenport Eye Group PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

DAVENPORT EYE GROUP PC

Practice address

1230 E Rusholme St
Ste 203
Davenport, IA 52803-2400

Phone

(563) 322-0923

Fax

(563) 322-7403

NPI assigned

Feb 1, 2006

Last updated

Sep 23, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Siv Brit Saetre, M.D.NPI 1013989441

Title

President

Phone

(563) 322-0923

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA2 enrollments

Enrollment records 2

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Siv Brit Saetre, M.D.

  • Ophthalmology Physician
  • Davenport, IA
  • NPI 1013989441
  Medicare reassignment NPD Authorized official
• Ashok R Penmatcha, M.D.

  • Ophthalmology Physician
  • Davenport, IA
  • NPI 1174595516
  Medicare reassignment NPD
• Leonardo Miguel Antaris, M.D.

  • Ophthalmology Physician
  • Davenport, IA
  • NPI 1679541973
  NPD (past)
• Tina J Eckhardt, M.D.

  • Ophthalmology Physician
  • Bettendorf, IA
  • NPI 1952373383
  NPD (past)

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253664000000",
    "number": "1508838954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 E RUSHOLME ST",
            "address_2": "STE 203",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032400",
            "telephone_number": "563-322-0923",
            "fax_number": "563-322-7403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 E RUSHOLME ST",
            "address_2": "STE 203",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032400",
            "telephone_number": "563-322-0923",
            "fax_number": "563-322-7403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVENPORT EYE GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-01",
        "last_updated": "2009-09-23",
        "status": "A",
        "authorized_official_last_name": "SAETRE",
        "authorized_official_first_name": "SIV",
        "authorized_official_middle_name": "BRIT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-322-0923",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0286468",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "CE7597",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nikki Dao-Hauritz, PA-C
• Kristyn Marie Darmafall, M.D.
• Tracy Dassie, PHARMD
• Davenport Clinic, P.C.
• Davenport Community School District
• Davenport Hearing Aid Center, Inc (Davenport Audiology Hearing Aid Center, Inc)
• Davenport Skilled Nursing Facility LLC (Harmony Davenport)
• Davenport Surgical Group PC
• Lindsay Jo Davenport, PA-C
• David Warren Schroeder

• Ophthalmology Physician in Davenport, IA
• Providers in Davenport, IA by specialty
• Ophthalmology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; 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.